DR. GREGG W CARLSON (NPI# 1043378912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043378912 |
| Entity Type | Individual |
| Full Name | DR. GREGG W CARLSON |
| Credential | MD |
| Practice Address |
310 S Penn St Ste 204 Aberdeen SD 57401-4553 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6052251636 |
| Practice Fax Number | 6052292434 |
| Mailing Telephone | 6056222857 |
| Mailing Fax Number | 6056222859 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2011-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 1897 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | ND MEDICAID | 15824 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972881951 | Gregg Carlson | Physician Assistant | 321 E 34th St, New York, NY 10016-4942 | 2011-07-25 |
| Street Address |
310 S PENN ST STE 204 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851394662 | Richard J Conklin | Internal Medicine | 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 | 2005-05-24 |
| 1407309057 | Chelsea R Westerman | Nurse Practitioner | 310 S Penn St, Suite 204, Aberdeen, SD 57401-4553 | 2016-08-01 |
| 1831504711 | Avera St Lukes | Clinic/Center | 310 S Penn St, Ste 201, Aberdeen, SD 57401 | 2014-06-30 |
| 1780004713 | Avera St Lukes | Radiology | 310 S Penn St, Suite 105, Aberdeen, SD 57401 | 2014-04-17 |
| 1912265489 | Avera St. Luke's | Internal Medicine | 310 S Penn St, Ste 203, Aberdeen, SD 57401 | 2012-05-02 |
| 1720376825 | Christopher L Nelson | Nurse Practitioner | 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 | 2011-07-11 |
| 1669769998 | Shanna M. Anderson | Nurse Practitioner | 310 S Penn St, Suite 203, Aberdeen, SD 57401-4553 | 2011-07-07 |
| 1154641595 | Charles L. Pelton Jr. | Physician Assistant | 310 S Penn St, Suite 202, Aberdeen, SD 57401-4553 | 2010-06-08 |
| 1720317118 | Avera St. Luke's | Obstetrics & Gynecology | 310 S Penn St, Suite 204, Aberdeen, SD 57401 | 2009-12-14 |
| 1780815506 | Avera St. Luke's | Neurological Surgery | 310 S Penn St, Suite 203, Aberdeen, SD 57401 | 2009-07-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679002950 | Brenda Lee Pence | Registered Nurse | 305 S. State St., Aberdeen, SD 57401 | 2017-06-08 |
| 1104366475 | Jordan Shangreaux | Specialist/Technologist | 2200 S Roosevelt St, Aberdeen, SD 57401 | 2017-03-06 |
| 1205387545 | Midwest Medical Transport Company, LLC-aberdeen, Sd | Ambulance | 2919 Industrial Avenue, Aberdeen, SD 57401 | 2016-10-21 |
| 1356752471 | Cameron Eichler Enterprises | Hearing Aid Equipment | 110 6th Ave Se Ste 106, Aberdeen, SD 57401 | 2014-05-12 |
| 1184059412 | Richard Allen Ward IIi | Hearing Instrument Specialist | 1315 6th Avenue Se, Suite 4, Aberdeen, SD 57401 | 2013-09-05 |
| 1427395540 | Matthew William Svensen | Physical Therapist | 1109 S Jay St, Aberdeen, SD 57401 | 2013-01-09 |
| 1750655940 | Robert Ashly Froke | Audiologist | 121 4th Ave Sw-suite 1, Natural Hearing Center, Aberdeen, SD 57401 | 2012-03-06 |
| 1457504862 | Rodney S Johnson | Counselor | 14 S Main St Ste 1e, Aberdeen, SD 57401 | 2008-10-29 |
| 1518115005 | Dakota Chiropractic of Aberdeen, PC | Chiropractor | 520 Moccasin Drive, Aberdeen, SD 57401 | 2008-09-09 |
| 1558554626 | Tiffany Zimmerman Hoeft | Speech-Language Pathologist | 39515 Pintail Ave, Aberdeen, SD 57401 | 2007-08-22 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245401603 | Ob-gyn Assoc of Aberdeen | Obstetrics & Gynecology | 310 South Penn St, Suite 204, Aberdeen, SD 57401-4553 | 2008-03-13 |
| 1780758417 | Scott Harrison Berry | Obstetrics & Gynecology | 310 So Penn St, Suite 204, Aberdeen, SD 57401 | 2006-11-17 |
| 1457467300 | Sulaiman A Bham | Obstetrics & Gynecology | 326 N Philadelphia Blvd, Aberdeen, MD 21001-1910 | 2006-08-22 |
| 1285652362 | John M Rees | Obstetrics & Gynecology | 1020 Anderson Dr Ste 202, Aberdeen, WA 98520-1055 | 2006-07-17 |
| 1720317118 | Avera St. Luke's | Obstetrics & Gynecology | 310 S Penn St, Suite 204, Aberdeen, SD 57401 | 2009-12-14 |
| 1376771881 | Breanne E Anderson-mueller | Obstetrics & Gynecology | 3015 3rd Ave Se, Aberdeen, SD 57401-5418 | 2009-06-24 |
| 1407010093 | Nicholas Hallak, Md, Pllc | Obstetrics & Gynecology | 1921 Sumner Avenue, Aberdeen, WA 98520 | 2008-07-14 |
| 1225239916 | Nicholas Hallak | Obstetrics & Gynecology | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2007-05-30 |
| 1598880833 | Carey R Martens | Obstetrics & Gynecology | 1006 N H St, 5th Floor, Aberdeen, WA 98520-2521 | 2007-03-19 |
| 1699814012 | Grays Harbor Womens Clinic Pllc | Obstetrics & Gynecology | 1020 Anderson Dr, Suite 202, Aberdeen, WA 98520-1055 | 2007-02-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.