Active NPI
Kristi L Carlson, PA-C
- Physician Assistant
- Tomah, WI
National Provider Identifier
1326020918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 743023
- Practice address
- 325 Butts Avenue
Tomah, WI 54660 - Phone
- (608) 372-5951
- Fax
- (608) 372-3436
- NPI assigned
- Nov 18, 2005
- Last updated
- Jan 7, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 743023 | WI | Primary |
Addresses
Primary practice location
325 Butts Avenue
Tomah, WI 54660
Mailing address
PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 743023 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1326020918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1510",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547021510",
"telephone_number": "608-785-0940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 BUTTS AVENUE",
"city": "TOMAH",
"state": "WI",
"postal_code": "54660",
"telephone_number": "608-372-5951",
"fax_number": "608-372-3436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "KRISTI",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "743023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.