Active NPI
Alec James Carlson, IDC
- Independent Duty Corpsman
- Jbphh, HI
National Provider Identifier
1265968424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- License
- CARLAJ138NJ
- Practice address
- 455 Hornet Ave Ste 101
Jbphh, HI 96860-3530 - Phone
- (619) 537-4355
- NPI assigned
- May 10, 2017
- Last updated
- Aug 31, 2021
- 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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | CARLAJ138NJ | WA | Primary |
Addresses
Primary practice location
455 Hornet Ave Ste 101
Jbphh, HI 96860-3530
Mailing address
Uss Typhoon PC 5
Unit 100286 Box 1
Fpo, AE 09588
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 |
|---|---|---|---|
| CARLAJ138NJ | WA | MD | Independent Duty Corpsman |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1265968424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "USS TYPHOON PC 5",
"address_2": "UNIT 100286 BOX 1",
"city": "FPO",
"state": "AE",
"postal_code": "09588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 HORNET AVE STE 101",
"city": "JBPHH",
"state": "HI",
"postal_code": "968603530",
"telephone_number": "619-537-4355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "ALEC",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-10",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": "WA",
"license": "CARLAJ138NJ",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbphh, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.