Active NPI
Jean Marie Carlson, P.T.
- Pediatric Physical Therapist
- Schererville, IN
National Provider Identifier
1992940845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 05002793A
- Practice address
- 7511 Foxwood Dr
Schererville, IN 46375-3359 - Phone
- (219) 864-5924
- Fax
- (219) 864-5924
- NPI assigned
- Dec 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 05002793A | IN | |
| Pediatric Physical Therapist | 2251P0200X | 05002793A | IN | Primary |
Addresses
Primary practice location
7511 Foxwood Dr
Schererville, IN 46375-3359
Mailing address
7511 Foxwood Dr
Schererville, IN 46375-3359
Phone (219) 864-5924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05002793A | IN | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228521600000",
"number": "1992940845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7511 FOXWOOD DR",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463753359",
"telephone_number": "219-864-5924",
"fax_number": "219-864-5924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7511 FOXWOOD DR",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463753359",
"telephone_number": "219-864-5924",
"fax_number": "219-864-5924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JEAN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-06",
"last_updated": "2008-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IN",
"license": "05002793A",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IN",
"license": "05002793A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schererville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.