Individual provider Active NPI

Katherine Anne Carlson, FNP-C

  • Family Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1750013348
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184595 Issued in VA
Practice address
435 Merchant Walk SQ Ste 400
Charlottesville, VA 22902-6516
Phone
(434) 654-1800
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184595 VA Primary

Addresses

Primary practice location

435 Merchant Walk SQ Ste 400
Charlottesville, VA 22902-6516

Mailing address

1200 Cutler LN
Charlottesville, VA 22901-3906
Phone (434) 242-7190

Other practice location 1

1200 Cutler Ln
Charlottesville, VA 22901-3906
Phone (434) 242-7190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220000775 VA Practitioner - Nurse Practitioner 8820460918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

435 Merchant Walk SQ
Suite 400
Charlottesville, VA 22902-6516
Phone (434) 654-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024184595VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC CurrentSince Nov 21, 2022 Accepting new patients
Martha Jefferson Hospital Past Accepting new patients

Locations

435 Merchant Walk Sq
Ste 400
Charlottesville, VA 22902
Phone (434) 654-1800

920 E High St
Ste 201
Charlottesville, VA 22902
Phone (434) 654-1950

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Interoperability endpoints

  • Direct secure messaging: kmorris255331@direct.sentara.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1750013348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CUTLER LN",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229013906",
            "telephone_number": "434-242-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MERCHANT WALK SQ STE 400",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229026516",
            "telephone_number": "434-654-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Cutler Ln",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229013906",
            "country_code": "US",
            "telephone_number": "434-242-7190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.