Individual provider Active NPI

Victoria Carlson, CNM, WHNP-BC

  • Obstetrics & Gynecology Nurse Practitioner
  • Oswego, NY
National Provider Identifier
1679379259
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
002380 Issued in NY
Practice address
42 Montcalm St
Oswego, NY 13126-1398
Phone
(315) 343-2590
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 002380 NY Primary

Addresses

Primary practice location

42 Montcalm St
Oswego, NY 13126-1398

Mailing address

42 Montcalm St
Oswego, NY 13126-1398
Phone (315) 343-2590

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)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
002380NYMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oswego County OB-GYN PC CurrentSince Jul 1, 1999 Accepting new patients

Locations

820 Phillips St
Fulton, NY 13069
Phone (315) 593-8393

42 Montcalm St
Oswego, NY 13126
Phone (315) 343-2590

140 W 6th St
Ste G60
Oswego, NY 13126
Phone (315) 343-2590

Organizations & group practices 1

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": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1679379259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MONTCALM ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261398",
            "telephone_number": "315-343-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MONTCALM ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131261398",
            "telephone_number": "315-343-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "VICTORIA",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "002380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.