Active NPI
Jamie Leigh Carlson
- Physical Therapist
- Brookfield, WI
National Provider Identifier
1154714756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14663
- Practice address
- 16985 W Bluemound Rd
Brookfield, WI 53005-5909 - Phone
- (262) 821-4460
- NPI assigned
- Mar 6, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14663 | WI | Primary |
| Athletic Trainer | 2255A2300X | 1648 | WI |
Addresses
Primary practice location
16985 W Bluemound Rd
Brookfield, WI 53005-5909
Mailing address
16985 W Bluemound Rd
Brookfield, WI 53005-5909
Phone (262) 821-4460
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14663 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1154714756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16985 W BLUEMOUND RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055909",
"telephone_number": "262-821-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16985 W BLUEMOUND RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055909",
"telephone_number": "262-821-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JAMIE",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-06",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14663",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "1648",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.