Jennifer Carlson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1002 Issued in AK

Practice address

1919 Lathrop St
Suite 123
Fairbanks, AK 99701-5937

Phone

(907) 455-4401

Fax

(907) 455-4402

NPI assigned

May 31, 2006

Last updated

Jul 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1871530865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST",
            "address_2": "SUITE 123",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015937",
            "telephone_number": "907-455-4401",
            "fax_number": "907-455-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENCE #",
            "identifier": "1002",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Eleanor Carlin
• Margaret Eileen Carlson Cosentino, DO
• Amy Katharine Carlson, LMSW
• Anders Harbord Carlson, PT
• Hannah Brooks Carlson
• Kimberly Carlson
• Heather M Carmichael, LAC
• Allison Carr, L.AC.
• Bruce Evan Carr, BA
• Kiana Marie Carr, LMFT

• Physical Therapist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.