Active NPI
Philip R Carlson, MD
- Diagnostic Radiology Physician
- Windsor, WI
National Provider Identifier
1750359832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 26265
- Practice address
- 6696 Wolf Hollow Rd
Windsor, WI 53598 - Phone
- (608) 842-0734
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 26265 | WI | |
| Diagnostic Radiology Physician | 2085R0202X | 26265 | WI | Primary |
Addresses
Primary practice location
6696 Wolf Hollow Rd
Windsor, WI 53598
Mailing address
6696 Wolf Hollow Rd
Windsor, WI 53598-9813
Phone (608) 842-0734
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26265 | WI | MD | Vascular & Interventional Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1750359832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6696 WOLF HOLLOW RD",
"city": "WINDSOR",
"state": "WI",
"postal_code": "535989813",
"telephone_number": "608-842-0734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6696 WOLF HOLLOW RD",
"city": "WINDSOR",
"state": "WI",
"postal_code": "53598",
"telephone_number": "608-842-0734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "PHILIP",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "WI",
"license": "26265",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "26265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.