Individual provider Active NPI

Jenna Marie Carlson, PHARMD

  • Pharmacist
  • Scottsdale, AZ
National Provider Identifier
1316248347
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S017243 Issued in AZ
Practice address
11275 E Via Linda
Scottsdale, AZ 85259-4073
Phone
(480) 451-1177
Fax
(480) 614-1214
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S017243 AZ Primary

Addresses

Primary practice location

11275 E Via Linda
Scottsdale, AZ 85259-4073

Mailing address

11275 E Via Linda
Scottsdale, AZ 85259-4073
Phone (480) 451-1177

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S017243AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1316248347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11275 E VIA LINDA",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594073",
            "telephone_number": "480-451-1177",
            "fax_number": "480-614-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 E VIA LINDA",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594073",
            "telephone_number": "480-451-1177",
            "fax_number": "480-614-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.