Carl Joseph Carlson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

17742 Issued in AZ

Practice address

13624 W Camino del Sol
Suite 150
Sun City West, AZ 85375-3405

Phone

(623) 546-0203

Fax

(623) 546-5841

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carl Joseph Carlson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1508893512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13624 W. CAMINO DEL SOL",
            "address_2": "SUITE 150",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853753405",
            "telephone_number": "623-546-0203",
            "fax_number": "623-546-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13624 W CAMINO DEL SOL",
            "address_2": "SUITE 150",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853753405",
            "telephone_number": "623-546-0203",
            "fax_number": "623-546-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CARL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "17742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARL",
            "last_name": "CARLSON",
            "middle_name": "JOSEPH",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Sun City West, AZ
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.