Victoria Carlson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

200959 Issued in CO

Practice address

172 Justice Center Rd
Canon City, CO 81212-9354

Phone

(719) 275-1626

Fax

(719) 275-4328

NPI assigned

May 3, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Fremont

  • Public Health or Welfare Agency
  • Canon City, CO
  • NPI 1013917921
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1144665142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 JUSTICE CENTER RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129354",
            "telephone_number": "719-275-1626",
            "fax_number": "719-275-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 JUSTICE CENTER RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129354",
            "telephone_number": "719-275-1626",
            "fax_number": "719-275-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "VICTORIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "200959",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R202539-7",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Canon Professional Wellness Clinic LLC
• Canon Professional, L.L.C.
• Tiffany Diane Cardinal
• Laurie Carle, PT
• Eric Carlson, MD
• Jordynne Carmichael-Green
• Elizabeth Crystal Carochi
• Molly Carpenter, MA
• Christopher M Carter
• Cascade Medical and Dental LLC

• Registered Nurse in Canon City, CO
• Providers in Canon City, CO by specialty
• Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.