Active NPI
Rolf S Carlson, PHD
- Psychiatry Physician
- Worthington, MN
National Provider Identifier
1346334836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C996
- Practice address
- 1216 Ryans Rd
Worthington, MN 56187-1722 - Phone
- (507) 372-2921
- Fax
- (507) 372-5789
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C996 | MN | Primary |
Addresses
Primary practice location
1216 Ryans Rd
Worthington, MN 56187-1722
Mailing address
1216 Ryans Rd
Worthington, MN 56187-1722
Phone (507) 372-2921
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800748900 | Medicaid | MN | |
| 620004999 | Other | MN | RR MEDICARE |
| 97749CA | Other | MN | BCBS MPIN |
| 115530 | Other | MN | UCARE |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C996 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364774400000",
"number": "1346334836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 RYANS RD",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871722",
"telephone_number": "507-372-2921",
"fax_number": "507-372-5789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1216 RYANS RD",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871722",
"telephone_number": "507-372-2921",
"fax_number": "507-372-5789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "ROLF",
"middle_name": "S",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2013-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "C996",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "800748900",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "620004999",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MPIN",
"identifier": "97749CA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "115530",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worthington, MN
- Jeffrey Dallas Campbell, D.M.D.
- Elena Canfield, M.D.
- Caring & Compassionate Health Care Agency LLC
- Caring & Compassionate Healthcare Agency LLC
- Paul Michael Carlson, D.D.S.
- Jenifer Castellanos Morales
- Cedar Chiropractic Services, P.a.
- Natalie Ann Cepress, OT
- Virginia Cerda, CHW
- Hannah Christensen, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.