Individual provider Active NPI

Kirsten Ann Carlson, ARNP

  • Acute Care Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1366955676
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP60909289 Issued in WA
Practice address
307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100
Phone
(360) 336-9757
Fax
(360) 814-5237
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60909289 WA
Student in an Organized Health Care Education/Training Program 390200000X
Acute Care Nurse Practitioner 363LA2100X AP60909289 WA Primary

Addresses

Primary practice location

307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other practice location 1

14442 Autumns Ave SE
Monroe, WA 98272-8318
Phone (425) 280-9167

Other practice location 2

328 S Stillaguamish Ave
Arlington, WA 98223-1660
Phone (360) 336-9757

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcarlson35998@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20210811004158 WA Practitioner - Nurse Practitioner 4981008083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

307 S 13TH St
Suite 300
Mount Vernon, WA 98274-4100
Phone (360) 336-9757

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60909289WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 19, 2021 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 19, 2021 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

328 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

307 S 13th St
Ste 300
Mount Vernon, WA 98274
Phone (360) 336-9757

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1366955676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST STE 300",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-336-9757",
            "fax_number": "360-814-5237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14442 Autumns Ave SE",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982728318",
            "country_code": "US",
            "telephone_number": "425-280-9167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "328 S Stillaguamish Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982231660",
            "country_code": "US",
            "telephone_number": "360-336-9757",
            "fax_number": "360-814-5237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KIRSTEN",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60909289",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60909289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarlson35998@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "307 S 13th St Ste 300",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.