Active NPI
David J Carlson, CRNA
- Certified Registered Nurse Anesthetist
- Fayetteville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- D114053
- Practice address
- 195 Roxboro CT
Fayetteville, GA 30215-5323 - Phone
- (770) 461-6244
- NPI assigned
- May 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | D114053 | IA | Primary |
Addresses
Primary practice location
195 Roxboro CT
Fayetteville, GA 30215-5323
Mailing address
195 Roxboro CT
Fayetteville, GA 30215-5323
Phone (770) 461-6244
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17294 | AL | MD | Emergency Medicine Physician |
| D114053 | IA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vaughan Regional Medical Center LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Clarksdale Hma LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Wallace Thomson Hospital | Past | Accepting new patients | |
| Nurse Anesthesia of North Carolina, PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Vaughan Regional Medical Center LLC | Past | Accepting new patients | |
| Pain Consultants, P.C. | Past | Accepting new patients |
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Clarksdale Phys Serv Anesthesia CRNA
- Anesthesiology Physician
- Clarksdale, MS
- NPI 1386679744
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Elizabeth City, NC
- NPI 1689628729
Nurse Anesthetist, Certified Registered
-
- Specialist
- Davenport, IA
- NPI 1952368383
-
dba Vaughan Regional Medical Center-Parkway Campus
- Anesthesiology Physician
- Selma, AL
- NPI 1114088846
Nurse Anesthetist, Certified Registered
-
dba Marion Clinic
- Rural Health Clinic/Center
- Marion, AL
- NPI 1770600066
-
- Medical Specialty Clinic/Center
- Union, SC
- NPI 1588872584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326085382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 ROXBORO CT",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302155323",
"telephone_number": "770-461-6244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 ROXBORO CT",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302155323",
"telephone_number": "770-461-6244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "DAVID",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D114053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.