Georgina Carlson, P.A.C – Physician Assistant

Key facts

NPI: 1821187162
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 000805 (CT)
Practice address: 131 Kent Rd
New Milford, CT 06776-3485
Phone: (860) 355-8000
Fax: (860) 350-6291
NPI assigned: Oct 12, 2006
Sex: Female
Sole proprietor: No

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.

Connecticut Family Orthopedics PC Orthopaedic Surgery Physician · Danbury, CT · NPI 1619057510

NPD (past)
Orthoconnecticut, PLLC Orthopaedic Surgery Physician · Danbury, CT · NPI 1770507345

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
000805	CT	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Connecticut Family Orthopedics PC		Past	Accepting new patients
Orthoconnecticut, PLLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	000805	CT	Yes

Addresses

Primary practice location

131 Kent Rd
New Milford, CT 06776-3485

Mailing address

131 Kent Rd
New Milford, CT 06776-3485
Phone (860) 355-8000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 6, 2015.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1821187162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 KENT RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763485",
            "telephone_number": "860-355-8000",
            "fax_number": "860-350-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 KENT RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763485",
            "telephone_number": "860-355-8000",
            "fax_number": "860-350-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "GEORGINA",
        "name_prefix": "Mrs.",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

All providers in New Milford, CT · Physician Assistant in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.