Active NPI
Ryan Robert Carlson, OTD, OTR/L
- Occupational Therapist
- Shenandoah, IA
National Provider Identifier
1255577425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01630
- Practice address
- 1309 Southmoreland PL
Shenandoah, IA 51601-2247 - Phone
- (712) 246-8179
- NPI assigned
- Dec 18, 2008
- Last updated
- Dec 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01630 | IA | Primary |
Addresses
Primary practice location
1309 Southmoreland PL
Shenandoah, IA 51601-2247
Mailing address
823 S 17TH St
P.O. Box 217
Clarinda, IA 51632-2625
Phone (712) 246-8224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01630 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1255577425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 S 17TH ST",
"address_2": "P.O. BOX 217",
"city": "CLARINDA",
"state": "IA",
"postal_code": "516322625",
"telephone_number": "712-246-8224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 SOUTHMORELAND PL",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516012247",
"telephone_number": "712-246-8179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "RYAN",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-18",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "01630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.