NPIMap

Organization Active NPI

Carlson Med Group

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1629383526
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3438 Issued in NV
Legal business name
CARLSON MED GROUP
Practice address
2245 N Green Valley Pkwy
Suite 566
Henderson, NV 89014-5024
Phone
(702) 418-6334
NPI assigned
Aug 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Authorized official

Name
Kurt Carlson
Title
Ceo
Phone
(702) 418-6334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3438 NV Primary

Addresses

Primary practice location

2245 N Green Valley Pkwy
Suite 566
Henderson, NV 89014-5024

Mailing address

2245 N Green Valley Pkwy
Suite 566
Henderson, NV 89014-5024

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1629383526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N GREEN VALLEY PKWY",
            "address_2": "SUITE 566",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890145024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N GREEN VALLEY PKWY",
            "address_2": "SUITE 566",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890145024",
            "telephone_number": "702-418-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON MED GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-418-6334"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "3438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.