NPIMap

Individual provider Active NPI

Craig K Carlson, PT

  • Physical Therapist
  • Redmond, WA
National Provider Identifier
1396722310
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00007837 Issued in WA
Practice address
8495 161St Ave NE
Redmond, WA 98052-3849
Phone
(425) 881-3001
Fax
(425) 881-3585
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00007837 WA Primary

Addresses

Primary practice location

8495 161St Ave NE
Redmond, WA 98052-3849

Mailing address

8495 161St Ave NE
Redmond, WA 98052-3849
Phone (425) 881-3001

Other identifiers 1

IdentifierTypeStateIssuer
8335697MedicaidWA

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

LicenseStateTypeSpecialty
PT00007837WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Pain Solutions PastSince Dec 6, 2020 Accepting new patients
Redmond Physical Therapy, Inc. Physical Therapist PastSince Oct 28, 2010 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1396722310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8495 161ST AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523849",
            "telephone_number": "425-881-3001",
            "fax_number": "425-881-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 161ST AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523849",
            "telephone_number": "425-881-3001",
            "fax_number": "425-881-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CRAIG",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335697",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.