Katie Carlson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002162A Issued in IN

Practice address

8840 Calumet Ave
Suite 103
Munster, IN 46321-2545

Phone

(219) 836-7246

NPI assigned

Nov 23, 2016

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1346783396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 106",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-242-5468",
            "fax_number": "888-724-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CALUMET AVE",
            "address_2": "SUITE 103",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212545",
            "telephone_number": "219-836-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8800 Virginia Pl Ste 106",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107109",
            "country_code": "US",
            "telephone_number": "219-736-1310",
            "fax_number": "219-756-3562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002162A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cardiovascular Surgery WTWK
• Jordyn Caridinedix
• Crisostomo J Carlos, MD
• Ilona Marie Carlos, MD
• Kathleen A Carlson, NURSE PRACTITIONER
• Catherine Carpenter, ED.D
• Brittany Marie Carr, PA-C
• James M Carr, PT
• Caryn Carranza, MD
• Priscilla Alyssa Carranza, PHARMD

• Physician Assistant in Munster, IN
• Providers in Munster, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.