NPIMap

Individual provider Active NPI

Timothy Drew Carlson, APRN

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1205646676
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4035311 Issued in KY
Practice address
1015 Dupont Rd
Louisville, KY 40207-4610
Phone
(502) 883-0227
NPI assigned
Jan 8, 2025
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4035311 KY Primary
Registered Nurse 163W00000X 1153868 KY

Addresses

Primary practice location

1015 Dupont Rd
Louisville, KY 40207-4610

Mailing address

10500 Watermark PL Apt 109
Louisville, KY 40223-0151

Other practice location 1

10500 Watermark Pl Apt 109
Louisville, KY 40223-0151
Phone (270) 703-6859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20251217002772 KY Practitioner - Nurse Practitioner 5890280804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Lung Care PLLCGroup PAC ID 5496910143, 8 clinicians

Practice addresses (Care Compare)

1015 Dupont Rd
Louisville, KY 40207-4610
Phone (502) 883-0227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1153868KYMDRegistered Nurse
4035311KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Lung Care PLLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

1015 DuPont Rd
Louisville, KY 40207
Phone (502) 883-0227

Organizations & group practices 1

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1205646676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 WATERMARK PL APT 109",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402230151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DUPONT RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074610",
            "telephone_number": "502-883-0227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10500 Watermark Pl Apt 109",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402230151",
            "country_code": "US",
            "telephone_number": "270-703-6859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TIMOTHY",
        "middle_name": "DREW",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4035311",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1153868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.