Active NPI
John E. Carlson, M.D.
- Specialist
- West Reading, PA
National Provider Identifier
1750386306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD-033442-E
- Practice address
- 301 S 7TH Ave
Ste 135
West Reading, PA 19611-1442 - Phone
- (610) 988-8925
- Fax
- (610) 988-8400
- NPI assigned
- Jun 19, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD-033442-E | PA | Primary |
Addresses
Primary practice location
301 S 7TH Ave
Ste 135
West Reading, PA 19611-1442
Mailing address
301 S 7TH Ave
Ste 135
West Reading, PA 19611-1442
Phone (610) 988-8925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215850 | Medicaid | PA |
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 |
|---|---|---|---|
| MD-033442-E | PA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750386306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S 7TH AVE",
"address_2": "STE 135",
"city": "WEST READING",
"state": "PA",
"postal_code": "196111442",
"telephone_number": "610-988-8925",
"fax_number": "610-988-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S 7TH AVE",
"address_2": "STE 135",
"city": "WEST READING",
"state": "PA",
"postal_code": "196111442",
"telephone_number": "610-988-8925",
"fax_number": "610-988-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JOHN",
"middle_name": "E.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD-033442-E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215850",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Reading, PA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.