Active NPI
Raymond Eugene Carlson, O.D.
- Optometrist
- Fresno, CA
National Provider Identifier
1811065378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9893T
- Practice address
- 3750 N Blackstone Ave
Fresno, CA 93726-5306 - Phone
- (559) 227-2529
- Fax
- (559) 227-2344
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9893T | CA | Primary |
Addresses
Primary practice location
3750 N Blackstone Ave
Fresno, CA 93726-5306
Mailing address
3750 N Blackstone Ave
Fresno, CA 93726-5306
Phone (559) 227-2529
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0098931 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9893T | CA | MD | Optometrist |
| 9893 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1811065378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3750 N BLACKSTONE AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937265306",
"telephone_number": "559-227-2529",
"fax_number": "559-227-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 N BLACKSTONE AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937265306",
"telephone_number": "559-227-2529",
"fax_number": "559-227-2344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "RAYMOND",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9893T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0098931",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.