NPIMap

Individual provider Active NPI

Todd J Carlson, M.D.

  • Family Medicine Physician
  • Port Townsend, WA
National Provider Identifier
1164475554
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00038106 Issued in WA
Practice address
915 Sheridan St
Suite B103
Port Townsend, WA 98368-2931
Phone
(360) 379-8031
Fax
(360) 385-0418
NPI assigned
May 18, 2006
Last updated
Sep 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00038106 WA Primary

Addresses

Primary practice location

915 Sheridan St
Suite B103
Port Townsend, WA 98368-2931

Mailing address

915 Sheridan St
Suite B103
Port Townsend, WA 98368-2931
Phone (360) 379-8031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110214000392 WA Practitioner - Family Practice 6800076514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 Sheridan St
Suite 101
Port Townsend, WA 98368-2901
Phone (360) 385-3500

915 Sheridan St
Port Townsend, WA 98368-2931
Phone (360) 379-8031

934 Sheridan St
Port Townsend, WA 98368-2957
Phone (360) 385-5338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Dec 23, 2010 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Dec 23, 2010 Accepting new patients
Jefferson County Public Hospital District No 2 Past Accepting new patients

Locations

1010 Sheridan St
Ste 101
Port Townsend, WA 98368
Phone (360) 379-8031

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

915 Sheridan St
Port Townsend, WA 98368
Phone (360) 379-8031

915 Sheridan St
Ste B103
Port Townsend, WA 98368
Phone (360) 379-8031

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Interoperability endpoints

  • Direct secure messaging: tcarlson295048@wm.providencedirect.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1164475554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SHERIDAN ST",
            "address_2": "SUITE B103",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682931",
            "telephone_number": "360-379-8031",
            "fax_number": "360-385-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SHERIDAN ST",
            "address_2": "SUITE B103",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682931",
            "telephone_number": "360-379-8031",
            "fax_number": "360-385-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TODD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00038106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.