Mary Lou Carlson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

27885 170TH Ave SW
Crookston, MN 56716-9444

Phone

(218) 281-3506

Fax

(218) 281-3015

NPI assigned

May 9, 2008

Sex

Female

Sole proprietor

No

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.

• Independence Plus Incorporate

  • Home Health Agency
  • Crookston, MN
  • NPI 1588720395
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2008.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1235306291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27885 170TH AVE SW",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567169444",
            "telephone_number": "218-281-3506",
            "fax_number": "218-281-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27885 170TH AVE SW",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567169444",
            "telephone_number": "218-281-3506",
            "fax_number": "218-281-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MARY",
        "middle_name": "LOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliver Buseth, LADC
• Shanon Erin Caillier, CNP
• Calming Waters Therapy PLLC
• Angela Marie Carlson, LICSW
• Jeanette Diane Carlson
• Eileen M Channel, CRNA
• Brynn Lara Charlesworth, M.D.
• Ioan John Chitu I
• Choice Therapy Crookston LLC
• Brittany Marie Christ

• All providers in Crookston, MN
• Personal Care Attendant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.