Theodore John Carlson, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

G4893 Issued in TX

Practice address

8210 Walnut Hill Lane
Suite 208
Dallas, TX 75231

Phone

(214) 363-0000

Fax

(214) 363-0713

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

Yes

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theodorecarlson@wnjrmc.allscriptsdirect.net

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.

• Magella Medical Associates Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071

  Pediatric Cardiology

  Medicare reassignment NPD
• Sherman Grayson Hospital LLC

  • General Acute Care Hospital
  • Sherman, TX
  • NPI 1013957836
  NPD

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1295784932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LANE",
            "address_2": "SUITE 208",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "214-363-0000",
            "fax_number": "214-363-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LANE",
            "address_2": "SUITE 208",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "214-363-0000",
            "fax_number": "214-363-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "THEODORE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "G4893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice F Carlsen, MS.CCC/A
• Corbin Carlson
• Moriah Paige Carlson, MD
• Rebecca Carlson
• Sarah Carlson
• Jacob Andrew Carlton, DMD
• Ronald Ray Carlton, PT
• William Alva Carlton, CO
• Yolande Carlton, PA-C
• Ashley Carlyle

• Pediatric Cardiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.