Philip John Carlson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3466-012 Issued in WI

Practice address

205 W Spence Street
Colby, WI 54421

Phone

(715) 223-1511

Fax

(715) 223-1411

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

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.

• Sport & Spine Clinic L.P.

  • Physical Therapist
  • Stratford, WI
  • NPI 1780020396
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891838488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W SPENCE ST.",
            "city": "COLBY",
            "state": "WI",
            "postal_code": "54421",
            "telephone_number": "715-223-1511",
            "fax_number": "715-223-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W SPENCE STREET",
            "city": "COLBY",
            "state": "WI",
            "postal_code": "54421",
            "telephone_number": "715-223-1511",
            "fax_number": "715-223-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "PHILIP",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3466-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Group Practice LLC
• Charles Lee Bauman, PT
• Amanda Lynn Beyer, B.S.N., R.N.
• Chad A Bogdonovich, PT
• Carlson Chiropractic Clinic LLC
• Colby Fire Department
• Colby School District
• Glynda Rae Gosse, R.N.
• Alicia Guden
• Kelsey Marie Halopka

• All providers in Colby, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.