Shoshannah Rose Carlson, CNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8105 Issued in MN

Practice address

6452 City West Pkwy
Eden Prairie, MN 55344-3245

Phone

(952) 999-0333

NPI assigned

Mar 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shoshannah Rose Pool Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Emily Program P C

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Paul, MN
  • NPI 1528165065
  Medicare reassignment NPD
• Emily Program PC

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1154696698
  NPD (past)

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616803200000",
    "number": "1205413994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 HAMPSHIRE AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554285135",
            "telephone_number": "612-578-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6452 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443245",
            "telephone_number": "952-999-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "SHOSHANNAH",
        "middle_name": "ROSE",
        "credential": "CNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2021-03-27",
        "certification_date": "2021-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHOSHANNAH",
            "last_name": "POOL",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick G Carey, MD
• Anna Carlen, MA, LADC
• Jordan Ann Carlson
• Kathryn Anne Carlson
• Nancy Fox Carlson, C.P.N.P.
• Kylie Carrier
• Shane Carriere
• Shannon Michael Carroll-Rolfe, DPT
• Josi Wylynn Carter, LADC
• Abby Casanova, RD, LD

• Family Nurse Practitioner in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.