Alisa Anne Carlson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

51476 Issued in WI

Practice address

12635 W. Bluemound Road
Brookfield, WI 53005-8004

Phone

(414) 258-0606

Fax

(414) 258-1953

NPI assigned

Nov 9, 2006

Last updated

Jun 17, 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

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: acarlson8227@direct.chw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Medical Group

  dba Glendale Pediatrics

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1912077686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 W. BLUEMOUND ROAD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058004",
            "telephone_number": "414-258-0606",
            "fax_number": "414-258-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ALISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "51476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912077686",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Care Connection Transit
• Care Lane Medical Transportation
• Care Management Wi LLC (Care Management Group)
• Care Point Health Solutions, LLC
• Carl F. Erck, DDS, S.C.
• Jamie Leigh Carlson
• Judith A Carlson, M.D.
• Abigail Carncross, LPC
• Jessica Carney
• Carol L Flanary, LLC

• Pediatrics Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.