Individual provider Active NPI

Nicole Lynsey Carlson, DPT

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1538685706
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302243 Issued in CA
Practice address
801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone
(866) 991-0900
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-32462 AZ
Physical Therapist 225100000X 10802 MN
Physical Therapist 225100000X 302243 CA Primary

Addresses

Primary practice location

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224

Mailing address

801 W Ann Arbor TRL Ste 220
Plymouth, MI 48170-6224
Phone (866) 991-0900

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

State licenses

LicenseStateTypeSpecialty
LPT-32462AZMDPhysical Therapist
302243CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blayne Robinson Liparoto Physical Therapist CurrentSince May 7, 2024 Accepting new patients
Monterey Spine & Joint PC CurrentSince Jan 7, 2023 Accepting new patients
Monterey Spine & Joint PC CurrentSince Jan 7, 2023 Accepting new patients
Montage Surgical Group Past Accepting new patients

Locations

12 Upper Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6060

21 Lower Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6040

4572 Telephone Rd
Ste 903
Ventura, CA 93003
Phone (805) 654-8127

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1538685706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W ANN ARBOR TRL STE 220",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706224",
            "telephone_number": "866-991-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "NICOLE",
        "middle_name": "LYNSEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32462",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10802",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.