Jennifer A Carlson, DNP, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60860636 Issued in WA

Practice address

5920 N Bridget St
Spokane, WA 99208-7062

Phone

(509) 581-3550

Fax

(509) 232-3309

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jennifer A Wankel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.carlson@161087654199300.direct.elationemr.com
• FHIR API: https://api.platform.athenahealth.com/25977/brand/1/csg/1/fhir/r4

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.

• Phoenix Health & Wellness PLLC

  • Exclusive Provider Organization
  • Spokane, WA
  • NPI 1245989292
  NPD Authorized official

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1407349871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W FRANCIS AVE # 502",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056512",
            "telephone_number": "509-581-3550",
            "fax_number": "509-232-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 N BRIDGET ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992087062",
            "telephone_number": "509-581-3550",
            "fax_number": "509-232-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ARNP.AP.60860636-NP",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "ARNP.AP.60860636-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60860636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2145049",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WANKEL",
            "middle_name": "A",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin Amanda Carlson, BEHAVIOR SPECIALIST
• Christel A Carlson, MD
• Darrin Carlson
• Deborah Carlson
• Emily Carlson, DPT
• Jonathan D Carlson, M.D.
• Matthew D Carlson, LMHC, LPC-S
• Megan Carlson, MA, LMHC
• Nicholas Ely Carlson, ATC, AT/L
• Patricia M Carlson, ARNP

• Nurse Practitioner in Spokane, WA
• Providers in Spokane, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.