Active NPI
Victoria Carlson
- Nurse Practitioner
- Queen Creek, AZ
National Provider Identifier
1265150957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 280163
- Practice address
- 21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709 - Phone
- (480) 512-3700
- NPI assigned
- Aug 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN199920 | AZ | |
| Nurse Practitioner | 363L00000X | 280163 | AZ | Primary |
Addresses
Primary practice location
21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709
Mailing address
21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709
Phone (480) 512-3700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | victoria.haun@bannerhealth.com | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner - University Super Specialists LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1740650555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1265150957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21772 S ELLSWORTH LOOP RD",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851427709",
"telephone_number": "480-512-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21772 S ELLSWORTH LOOP RD",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851427709",
"telephone_number": "480-512-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "VICTORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-18",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "RN199920",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "280163",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "victoria.haun@bannerhealth.com",
"affiliation": "N",
"endpointDescription": "work email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "21772 S Ellsworth Loop Rd",
"city": "Queen Creek",
"state": "AZ",
"country_code": "US",
"postal_code": "851427709",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.