Individual provider Active NPI

Alexandra Carlson

  • Addiction (Substance Use Disorder) Registered Nurse
  • SLC, UT
National Provider Identifier
1437406790
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
8279919-3102 Issued in UT
Practice address
344 E 100 S Ste 301
SLC, UT 84111-1727
Phone
(801) 322-4257
NPI assigned
Aug 6, 2012
Last updated
Aug 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 8279919-3102 UT Primary

Addresses

Primary practice location

344 E 100 S Ste 301
SLC, UT 84111-1727

Mailing address

6482 S Westbrook Dr
Salt Lake City, UT 84129-6145

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8279919-3102UTMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1437406790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6482 S WESTBROOK DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841296145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 100 S STE 301",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841111727",
            "telephone_number": "801-322-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "8279919-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.