Teri L Carlson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

52302 Issued in CO

Practice address

4440 Arapahoe Ave Ste 220
Boulder, CO 80303-9100

Phone

(303) 395-4727

Fax

(720) 328-5596

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 11, 2018 through Jun 11, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1912910605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 ARAPAHOE AVE STE 220",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803039100",
            "telephone_number": "303-395-4727",
            "fax_number": "720-328-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 ARAPAHOE AVE STE 220",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803039100",
            "telephone_number": "303-395-4727",
            "fax_number": "720-328-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TERI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A85442",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "52302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Snow Carlson, M.D.
• Deborah Carlson
• Heather Jane Carlson, MA, MFTC
• Mary K. Carlson, DDS
• Sarah Therese Carlson, LMFT
• Carly Sedgwick, LLC
• Carlyle Cardiovascular Consultants PLLC
• Renee Stacey Carman, CCC-SLP
• Carol Benjamin, PT, LLC
• Carol Hathaway-Clark, PH.D., LLC

• Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.