Breanna Carlson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-007870 Issued in AZ

Practice address

4350 E Ray Rd Ste 101a
Phoenix, AZ 85044-4707

Phone

(480) 704-5954

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

No

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 AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Solace Pediatric Healthcare Therapy Services Az, Inc.

  dba Care Options For Kids

  • Physical Therapist
  • Tempe, AZ
  • NPI 1669533105

  Occupational Therapist

  Medicare reassignment NPD
• Desert Valley Pediatric Therapy

  • Specialist
  • Phoenix, AZ
  • NPI 1528209830
  NPD
• Pioneer Pet, LLC

  • Diagnostic Radiology Physician
  • Tempe, AZ
  • NPI 1265401996
  NPD (past)

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1316590607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 W LOUGHLIN DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252124",
            "telephone_number": "480-390-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD STE 101A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444707",
            "telephone_number": "480-704-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-007870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Lena Carlos
• Carin M Carlsen, M.A. CCC-SLP
• Carlson & Palmer PC (The Marriage & Family Institute)
• Aimee Carlson, PHARMD
• Benjmamin Thomas Carlson, PTA
• Breanna Kay Carlson, DO
• Calli Carlson
• Kathryn Carlson
• Kelly Blanche Carlson, M.C.
• Kylie Suzanne Carlson, COTA, ATC

• Occupational Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.