Tina Marie Carlson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

076986-23 Issued in NH

Practice address

1105 SE Jetty Ave Ste C
Lincoln City, OR 97367-2604

Phone

(541) 614-0482

NPI assigned

Apr 11, 2022

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

Medicare fee-for-service enrollment

Enrolled in OR

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

Merit-based Incentive Payment System (MIPS)

Final score

93.65 of 100Reported as group

Quality

86.8

Promoting interoperability

100

Improvement activities

40

Cost

86.36

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225
  Medicare reassignment NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Sheridan, OR
  • NPI 1053873919
  NPD
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Nehalem, OR
  • NPI 1568808285
  NPD

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1245972181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2D MANOR DR",
            "city": "HOOKSETT",
            "state": "NH",
            "postal_code": "031061729",
            "telephone_number": "907-301-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE JETTY AVE STE C",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672604",
            "telephone_number": "541-614-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "076986-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Lynn Brewer-Dally, RN
• Adriana Buer
• Joseph Robert Bullock, DDS
• Caring for the Pacific LLC
• Angela M Carlson, APRN, PMHNP-BC
• Gregory P. Carozza, D.O.
• Heather Braud Carter, RPH
• Kate Gillespie Case, PT
• Michael Golden Cheek, MD
• Amanda Suzanne Cherryholmes

• Family Nurse Practitioner in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.