Jacqueline Carlson, RD CDE

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

DN006773 Issued in PA

Practice address

145 W 23Rd St
Erie, PA 16502-2858

Phone

(814) 835-2626

Fax

(814) 835-2646

NPI assigned

Oct 31, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Education and Research Institute IncGroup PAC ID 3870405137, 297 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.9 of 100Reported as apm

Quality

85.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477
  Medicare reassignment Care Compare group NPD
• Allegheny Clinic

  dba AHN Primary Care Mobile Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1942291935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 202",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-835-2626",
            "fax_number": "814-835-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-835-2626",
            "fax_number": "814-835-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JACQUELINE",
        "credential": "RD CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "000806",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "PA",
            "license": "DN006773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "005261701",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "051101000071",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andreea Carlia
• Drew James Carlin, D.M.D.
• Tracy Lynn Carlini, LSW
• Taylor Michele Carlotti
• Erin Carlson, PHARMD
• Jestin Carlson, M.D.
• Theresa M Carlucci, CRNP
• Carly Patterson Counseling Services
• Casey Carnell, PA-C
• John Michael Carney, MD

• Metabolic Nutrition Registered Dietitian in Erie, PA
• Providers in Erie, PA by specialty
• Metabolic Nutrition Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.