Individual provider Active NPI

Erin Marie Carlquist, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tallahassee, FL
National Provider Identifier
1245670082
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME135560 Issued in FL
Practice address
1899 Eider CT
Tallahassee, FL 32308
Phone
(850) 878-5143
Fax
(850) 942-6622
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R2300 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME135560 FL Primary

Addresses

Primary practice location

1899 Eider CT
Tallahassee, FL 32308

Mailing address

PO Box 14389
Tallahassee, FL 32317-4389
Phone (850) 878-5143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723000830 FL Practitioner - Pathology 7214152362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1899 Eider CT
Tallahassee, FL 32308-4537
Phone (850) 878-5143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2300TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ketchum Wood & Burgert Chartered DRS Ketchum Wood & Burgert Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2018 Accepting new patients
Ketchum Wood & Burgert Chartered DRS Ketchum Wood & Burgert CurrentSince May 1, 2018 Accepting new patients

Locations

1899 Eider Ct
Tallahassee, FL 32308
Phone (850) 878-5143

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1245670082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14389",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323174389",
            "telephone_number": "850-878-5143",
            "fax_number": "850-942-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 EIDER CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-878-5143",
            "fax_number": "850-942-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLQUIST",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "R2300",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME135560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.