Carlson Gi Clinic

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

CARLSON GI CLINIC

Practice address

420 Dewey Street
Wisconsin Rapids, WI 54495-0005

Phone

(715) 421-1001

Fax

(715) 421-3004

NPI assigned

Aug 10, 2006

Last updated

Jul 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly A Carlson, MBA

Title

Director of Operations

Phone

(715) 421-1001

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joel M Carlson, M.D.

  • Gastroenterology Physician
  • Wisconsin Rapids, WI
  • NPI 1063423515
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1881605335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DEWEY STREET",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544950005",
            "telephone_number": "715-421-1001",
            "fax_number": "715-421-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DEWEY STREET",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544950005",
            "telephone_number": "715-421-1001",
            "fax_number": "715-421-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON GI CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "715-421-1001",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Bullock, RN
• Nicole L Burlingame
• Mackenzie Buttles, OTR/L
• Jessica Lynn Cahill, PA
• Tonya Lyn Krueger Callahan, MS CRC LPC
• Joel M Carlson, M.D.
• Erica Carpenter, LPN
• Alexis N Case, RN
• Connie K Casey, C.R.N.A.
• Samantha Casey, LPC

• Gastroenterology Physician in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Gastroenterology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.