Nathanial James Carlson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2012023494 Issued in MO

Practice address

3801 Selsa Rd
Suite 7
Independence, MO 64057-1705

Phone

(816) 795-0434

Fax

(816) 795-0482

NPI assigned

Aug 1, 2012

Last updated

Aug 1, 2012By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Boost Sports Performance, LLC

  dba Boost Physical Therapy & Sports Performance

  • Physical Therapy Clinic/Center
  • Lee's Summit, MO
  • NPI 1548428931
  NPD (past)

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1700132321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 SW SENSATION DR",
            "address_2": "APARTMENT 931",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640817800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SELSA RD",
            "address_2": "SUITE 7",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571705",
            "telephone_number": "816-795-0434",
            "fax_number": "816-795-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "NATHANIAL",
        "middle_name": "JAMES",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012023494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carefree Mobility LLC
• Carepoint Revenue Health Solutions LLC
• Caring Mentors
• Paul Carlisle Jr., ED.D.
• Annamay D Carlson, DO
• Carmel Hills Healthcare and Rehabilitation Center, LLC (Carmel Hills Healthcare and Rehabilitation Center)
• Carmel Hills Mo Consulting LLC (Polaris Health & Wellness of Carmel Hills)
• Jessica Carney, COTA
• Karmel L Carothers, M.D.
• Laurie Lynn Carpenter, LCSW, LSCSW

• Physical Therapist in Independence, MO
• Providers in Independence, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.