Active NPI
Pamela Jeanne Carlson, CRNA
- Certified Registered Nurse Anesthetist
- Espanola, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R53755
- Practice address
- 1010 Spruce St
Espanola, NM 87532-2724 - Phone
- (505) 753-7111
- NPI assigned
- Jul 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | R53755 | NM | Primary |
Addresses
Primary practice location
1010 Spruce St
Espanola, NM 87532-2724
Mailing address
10B Abs Rd
Santa Fe, NM 87506-7906
Phone (949) 235-6080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73839370 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R53755 | NM | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Netherlands Anesthesia, LLC | Current | Accepting new patients | |
| Nurse Anesthesia of North Carolina, PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040
1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340
1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Las Vegas, NM
- NPI 1922603562
-
- Certified Registered Nurse Anesthetist
- Elizabeth City, NC
- NPI 1689628729
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Espanola Hospital
- Rural Acute Care Hospital
- Espanola, NM
- NPI 1154307593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740206473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10B ABS RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875067906",
"telephone_number": "949-235-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 SPRUCE ST",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322724",
"telephone_number": "505-753-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "PAMELA",
"middle_name": "JEANNE",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "R53755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "73839370",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Espanola, NM
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.
- 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.