Carlson Sports Medicine PC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1593 Issued in AZ

Legal business name

CARLSON SPORTS MEDICINE PC

Practice address

1534 E Fairfield St
Mesa, AZ 85203-5030

Phone

(480) 350-3800

NPI assigned

Aug 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Christopher R Carlson, PA

Title

President

Phone

(480) 350-3800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1218240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218240000000",
    "number": "1356597363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31917",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852751917",
            "telephone_number": "480-350-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 E FAIRFIELD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852035030",
            "telephone_number": "480-350-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-09",
        "last_updated": "2008-08-09",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-350-3800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Carlisle
• Carlos L Grandela O.D. PLC
• Adam Carlson
• Chelsea June Carlson
• Christopher R Carlson, PA-C, ATC
• Edward H. Carlson, DDS
• Ginger Apling Carlson, PHD

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.