Trevor E Carlson, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT38366 Issued in CA

Practice address

1585 Heartwood Dr Ste H
McKinleyville, CA 95519-3993

Phone

(707) 839-1802

Fax

(707) 839-3507

NPI assigned

Nov 2, 2011

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1982980082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 DEAN ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013209",
            "telephone_number": "707-443-8354",
            "fax_number": "707-443-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 HEARTWOOD DR STE H",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193993",
            "telephone_number": "707-839-1802",
            "fax_number": "707-839-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TREVOR",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT38366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "38366",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "CH2219",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Bryan, CNM NP PP
• Keoki Burbank
• Devon Thomas Burg, MA
• Deann Sabrina Campbell, NP
• Carelink Medical Transportation LLC
• William Peter Carlson, MD
• Bonnie M. Carroll, L.C.S.W.
• Joseph Edgar Carroll, MD
• Kari Greene Cheek
• Camela Anne Cooper Claros

• Specialist in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.