Individual provider Active NPI

Jon K Carlson, MD

  • Family Medicine Physician
  • Oshkosh, WI
National Provider Identifier
1639188782
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40091 Issued in WI
Practice address
855 N Westhaven Dr
Oshkosh, WI 54904
Phone
(920) 303-8700
Fax
(920) 303-8832
NPI assigned
Aug 7, 2006
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40091 WI Primary

Addresses

Primary practice location

855 N Westhaven Dr
Oshkosh, WI 54904

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Other practice location 1

600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 702-6371

Other practice location 2

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 702-6371

Other practice location 3

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 702-6371

Other identifiers 1

IdentifierTypeStateIssuer
32541100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jcarlson43712@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000440 WI Practitioner - Family Practice 8224169933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Aamg Reach PLLCGroup PAC ID 5597133264, 52 clinicians
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (920) 454-8401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40091WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 19, 2000 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Jan 20, 2026 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Jul 19, 2000 Accepting new patients
Aamg Reach PLLC Family Medicine CurrentSince Sep 22, 2022 Accepting new patients
Thedacare, Incorporated PastSince Jan 20, 2026 Accepting new patients

Locations

3925 N Gateway Dr
Appleton, WI 54913
Phone (920) 702-6371

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

12500 W Bluemound Rd
Elm Grove, WI 53122
Phone (262) 780-3434

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

333 N Green Bay Rd
Neenah, WI 54956
Phone (920) 725-2070

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1639188782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-303-8700",
            "fax_number": "920-303-8832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046926",
            "country_code": "US",
            "telephone_number": "920-702-6371",
            "fax_number": "920-993-5037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3925 N Gateway Dr",
            "address_purpose": "LOCATION",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137863",
            "country_code": "US",
            "telephone_number": "920-702-6371",
            "fax_number": "920-993-5037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561954",
            "country_code": "US",
            "telephone_number": "920-702-6371",
            "fax_number": "920-993-5037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JON",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32541100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcarlson43712@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.