Active NPI
Mallory E Carlson, L.AC
- Acupuncturist
- Minneapolis, MN
National Provider Identifier
1437637865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1722
- Practice address
- 2545 Chicago Ave Ste G10
Minneapolis, MN 55404-4569 - Phone
- (612) 353-6318
- NPI assigned
- Jul 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1722 | MN | Primary |
Addresses
Primary practice location
2545 Chicago Ave Ste G10
Minneapolis, MN 55404-4569
Mailing address
1631 Selby Ave Apt 4
Saint Paul, MN 55104-6273
Phone (612) 800-4297
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1722 | MN | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532736000000",
"number": "1437637865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 SELBY AVE APT 4",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046273",
"telephone_number": "612-800-4297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2545 CHICAGO AVE STE G10",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044569",
"telephone_number": "612-353-6318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "MALLORY",
"middle_name": "E",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-28",
"last_updated": "2018-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.