1043236565 NPI number — THOMAS E. CARSON, M.D., P.A.

Table of content: (NPI 1043236565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043236565 NPI number — THOMAS E. CARSON, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS E. CARSON, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043236565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1259 S PINELLAS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARPON SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34689-3719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-938-1908
Provider Business Mailing Address Fax Number:
727-938-8693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1259 S PINELLAS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TARPON SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34689-3719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-938-1908
Provider Business Practice Location Address Fax Number:
727-938-8693
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARSON
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
727-938-1908

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME36578 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: OS9655 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: ME108731 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: ME110547 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA9105368 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: ARNP1658442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: ARNP3391502 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: ARNP3391502 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004037600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1043236565 . This is a "NPI GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1962733261 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1316337769 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1427058791 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1376544049 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1417114737 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 002575201 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 039716400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1053624221 . This is a "NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 274337000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1154313997 . This is a "NPI NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 002575200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004107200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005549700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1487926861 . This is a "NPI GROUP NUMBER TRINITY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 304782201 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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