Active NPI
Laura Marie Carlson, MD
- Psychiatry Physician
- Tucson, AZ
National Provider Identifier
1679797914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 34565
- Practice address
- 39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091 - Phone
- (520) 624-4000
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 34565 | AZ | Primary |
Addresses
Primary practice location
39580 S Lago del Oro Pkwy
Tucson, AZ 85739-1091
Mailing address
12068 N Tall Grass Dr
Oro Valley, AZ 85755-8740
Phone (646) 425-9561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 24, 2022 through Jun 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34565 | AZ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679797914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12068 N TALL GRASS DR",
"city": "ORO VALLEY",
"state": "AZ",
"postal_code": "857558740",
"telephone_number": "646-425-9561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39580 S LAGO DEL ORO PKWY",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857391091",
"telephone_number": "520-624-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "LAURA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "34565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.