Casey Dean Carlson, ATC

Key facts

NPI

1619429271

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

License

2401142 (KS)

Practice address

1800 College Ave
Manhattan, KS 66502-3308

Phone

(785) 532-7244

Fax

(785) 532-1776

NPI assigned

Oct 31, 2016

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 4, 2016.

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1619429271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665023308",
            "telephone_number": "785-532-7244",
            "fax_number": "785-532-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665023308",
            "telephone_number": "785-532-7244",
            "fax_number": "785-532-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CASEY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "2401142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "2000010876",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF ATHLETIC TRAINERS",
            "identifier": "AT002151",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS BOARD OF HEALING ARTS ATHLETIC",
            "identifier": "2401142",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF REGULATORY AGENCIES ATHLETIC TRAINING",
            "identifier": "AT.0001391",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kevin M Carranza, CRNA
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• John David Carson, T-LMAC
• David L Carver, D.C.

All providers in Manhattan, KS · Athletic Trainer in Kansas