Active NPI
Eric Carlson, MD
- Orthopaedic Surgery Physician
- Canon City, CO
National Provider Identifier
1477532810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 30252
- Practice address
- 933 Sell Ave
Suite a
Canon City, CO 81212-4900 - Phone
- (719) 275-0685
- Fax
- (719) 275-0690
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 30252 | CO | Primary |
Addresses
Primary practice location
933 Sell Ave
Suite a
Canon City, CO 81212-4900
Mailing address
PO Box 310
Canon City, CO 81215-0310
Phone (719) 275-0685
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159056900 | Other | US DEPT OF LABOR | |
| 5502AMPR005587 | Other | ANTHEM BCBS NASCO BLUE CA | |
| 29405 | Other | ANTHEM BCBS | |
| P00262002 | Other | CO | RAILROAD MEDICARE |
| 01302520 | Medicaid | CO |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30252 | CO | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246924800000",
"number": "1477532810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 310",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812150310",
"telephone_number": "719-275-0685",
"fax_number": "719-275-0690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 SELL AVE",
"address_2": "SUITE A",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812124900",
"telephone_number": "719-275-0685",
"fax_number": "719-275-0690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "ERIC",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2009-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CO",
"license": "30252",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "159056900",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS NASCO BLUE CA",
"identifier": "5502AMPR005587",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "29405",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00262002",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01302520",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.