Individual provider Active NPI

Dustin James Carlson, DNP, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1194447334
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61478226 Issued in WA
Practice address
721 S Auburn St
Kennewick, WA 99336-5629
Phone
(509) 547-2204
Fax
(509) 542-8836
NPI assigned
Sep 14, 2022
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60651641 WA
Family Nurse Practitioner 363LF0000X AP61478226 WA Primary

Addresses

Primary practice location

721 S Auburn St
Kennewick, WA 99336-5629

Mailing address

PO Box 1452
Pasco, WA 99301-1223
Phone (509) 547-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925002065 WA Practitioner - Nurse Practitioner 1355795337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Community HealthGroup PAC ID 4183517469, 25 clinicians

Practice addresses (Care Compare)

721 S Auburn St
Kennewick, WA 99336-5629
Phone (509) 547-2204

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60651641WAMDRegistered Nurse
AP61478226WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Community Health CurrentSince Oct 1, 2023 Accepting new patients
Tri-Cities Community Health Current Accepting new patients
Tri-Cities Community Health Past Accepting new patients
Tri Cities Community Health Past Accepting new patients

Locations

3180 W Clearwater Ave
Ste A
Kennewick, WA 99336

721 S Auburn St
Kennewick, WA 99336
Phone (509) 543-8518

515 W Court St
Pasco, WA 99301
Phone (509) 545-3020

829 Goethals Dr
Richland, WA 99352
Phone (509) 713-7331

915 Goethals Dr
Richland, WA 99352
Phone (509) 946-3700

Interoperability endpoints

  • Direct secure messaging: dustin.carlson.1@21034.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1194447334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1452",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011223",
            "telephone_number": "509-547-2204",
            "fax_number": "509-542-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 S AUBURN ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365629",
            "telephone_number": "509-547-2204",
            "fax_number": "509-542-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DNP, ARNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60651641",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61478226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.