Marie McDermott Carlson, DNP, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024175214 Issued in VA

Practice address

8550 Santa Monica Blvd FL 2
West Hollywood, CA 90069-4496

Phone

(909) 962-1260

NPI assigned

Oct 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Parsley Medical Group FL PA

  • General Practice Physician
  • Des Moines, IA
  • NPI 1316704778
  NPD (past)
• Parsley Medical Group FL PA

  • General Practice Physician
  • Orlando, FL
  • NPI 1437722436
  NPD (past)

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1750892741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 SANTA MONICA BLVD FL 2",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694496",
            "telephone_number": "909-962-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 SANTA MONICA BLVD FL 2",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694496",
            "telephone_number": "909-962-1260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4445 Corporation Ln Ste 259",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623262",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7014 13th Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112281604",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5575 S Semoran Blvd Ste 36",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328221782",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1003 Bishop St Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968136475",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 New Hampshire Ave Ste 125",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038012907",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1623 Central Ave Ste 18",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014531",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 W Main St Ste 1460",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837025983",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8421 University Blvd Ste M",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503251036",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MARIE",
        "middle_name": "MCDERMOTT",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "TPAN313",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "47645",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "084907-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "68512",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347968-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A168159",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-3283",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175214",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024175214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassir Caravan, MD
• Diane Caraveo
• Carenodes
• Trevor Carle, MD
• Gabriela Yadira Carlos, D.C.
• Paul A Carlton, MD
• Carragher Osteopathic Inc.
• William Michael Carragher III, D.O.
• Carrie R Schwartz Chiropractic, PC
• Chelsea Carroll

• Nurse Practitioner in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.