Active NPI
David A Carlson, CRNA
- Certified Registered Nurse Anesthetist
- Albuquerque, NM
National Provider Identifier
1679575815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R51211
- Practice address
- 1100 Central Ave SE
Albuquerque, NM 87106-4930 - Phone
- (505) 841-1234
- Fax
- (505) 841-1956
- NPI assigned
- Jun 1, 2005
- Last updated
- Feb 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R51211 | NM | Primary |
Addresses
Primary practice location
1100 Central Ave SE
Albuquerque, NM 87106-4930
Mailing address
1720 Louisiana Blvd NE
Ste 401
Albuquerque, NM 87110-7020
Phone (505) 260-4300
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM006892 | Other | NM | BLUE CROSS BLUE SHIELD |
| 835069 | Medicaid | AZ | |
| 84746 | Medicaid | NM | |
| 942054 | Other | NM | PRONET / AETNA |
| 91575257 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R51211 | NM | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1679575815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 LOUISIANA BLVD NE",
"address_2": "STE 401",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871107020",
"telephone_number": "505-260-4300",
"fax_number": "505-260-4371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CENTRAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064930",
"telephone_number": "505-841-1234",
"fax_number": "505-841-1956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "DAVID",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "R51211",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "NM006892",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "835069",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "84746",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRONET / AETNA",
"identifier": "942054",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "91575257",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.