Jodi L. Carson Nurse Practitioner in Psychiatry

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

JODI L. CARSON NURSE PRACTITIONER IN PSYCHIATRY

Practice address

939 Route 146 Ste 620
Clifton Park, NY 12065-3629

Phone

(518) 414-5706

NPI assigned

Nov 25, 2024

Organization subpart

No

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

Authorized official

Name

Jodi L Carson, NP

Title

Owner

Phone

(518) 416-0359

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tree of Life Total Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Carson, PA

  • Physician Assistant
  • Clifton Park, NY
  • NPI 1336232594
  NPD

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1962228973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 GROOMS RD # 130",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 ROUTE 146 STE 620",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653629",
            "telephone_number": "518-414-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI L. CARSON NURSE PRACTITIONER IN PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-416-0359",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609521145",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tree of Life Total Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James McDonnell Inc
• Janet Allwood, DDS, PC
• Majd Jauhary-Nayfeh, MS, RD, CDN
• Kimyah M Jean-Charles, LMHC
• JH Counseling Services LCSW PLLC
• John Graham DC PC
• Alexis Johnson
• Sunny Dale Johnson, PHARM.D
• Tara Lynn Johnson
• Olivia Therese Jones, DPT

• Psychiatric/Mental Health Nurse Practitioner in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.