Active NPI
Christopher R Carlson, PA-C, ATC
- Surgical Physician Assistant
- Mesa, AZ
National Provider Identifier
1144220526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 1593
- Practice address
- 4824 E Baseline Rd
Suite 113
Mesa, AZ 85206-4676 - Phone
- (480) 350-3800
- NPI assigned
- Jul 28, 2005
- Last updated
- Feb 5, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1593 | AZ | |
| Surgical Physician Assistant | 363AS0400X | 1593 | AZ | Primary |
Addresses
Primary practice location
4824 E Baseline Rd
Suite 113
Mesa, AZ 85206-4676
Mailing address
PO Box 31917
Mesa, AZ 85275-1917
Phone (480) 350-3800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153982 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afc Physical Medicine of Gilbert, PLLC | Past | Accepting new patients | |
| Advanced Healthcare LLC | Past | Accepting new patients |
Interoperability endpoints
- ccarlson@direct.uspi.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- Mesa, AZ
- NPI 1356597363
-
- General Practice Physician
- Apache Junction, AZ
- NPI 1619225869
-
- Physical Medicine & Rehabilitation Physician
- Gilbert, AZ
- NPI 1528345881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1144220526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31917",
"city": "MESA",
"state": "AZ",
"postal_code": "852751917",
"telephone_number": "480-350-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4824 E BASELINE RD",
"address_2": "SUITE 113",
"city": "MESA",
"state": "AZ",
"postal_code": "852064676",
"telephone_number": "480-350-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "CHRISTOPHER",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "PA-C, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "1593",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "AZ",
"license": "1593",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "153982",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.