Nicole Lynn Carlson, MHS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22005059A Issued in IN

Practice address

9594 Lee PL
Crown Point, IN 46307-7458

Phone

(219) 384-6295

Fax

(219) 365-5857

NPI assigned

Aug 5, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Peru, IN
  • NPI 1750764494

  Speech-Language Pathologist

  Medicare reassignment NPD
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1699089276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9594 LEE PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077458",
            "telephone_number": "219-384-6295",
            "fax_number": "219-365-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9594 LEE PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077458",
            "telephone_number": "219-384-6295",
            "fax_number": "219-365-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "MHS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005059A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Natalie Cannizzo
• Cardiac Care Associates, Inc.
• Caring Hands Homes LLC
• Jill Carley, RN MSN NP
• Connie Kay Carlson, PTA
• Kimberly Carnegie Briscoe, PHD/DSW
• Carol'S Home Care Company
• Alyssa Dorothy-Lee Carter
• Yarelis Carter, RBT
• Andrea Leigh Cartwright

• Speech-Language Pathologist in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.