JAY W CARLSON (NPI# 1194835181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194835181 |
| Entity Type | Individual |
| Full Name | JAY W CARLSON |
| Credential | D.O. |
| Practice Address |
2055 S Fremont Ave Ste 200 Springfield MO 65804-2206 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 4178203554 |
| Practice Fax Number | 4178203587 |
| Mailing Telephone | 4178294620 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
2011006588 | MO | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
4038 | IA | Allopathic & Osteopathic Physicians |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
JC015918 | MI | Allopathic & Osteopathic Physicians |
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
4038 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200454170A | 05 | |
| AR | 187019003 | 05 | |
| MO | 1194835181 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831227743 | Jay C Carlson | Psychiatry & Neurology | 4495 Hale Parkway, Suite 210, Denver, CO 80220 | 2007-03-01 |
| Street Address |
2055 S FREMONT AVE STE 200 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376533927 | Hyewon Helen Kim | Radiology | 2055 S Fremont Ave, Springfield, MO 65804-2206 | 2005-10-25 |
| 1154733806 | Vanessa Mcconnell | Nurse Practitioner | 2055 S Fremont Ave, Ste 200, Springfield, MO 65804-2206 | 2014-05-29 |
| 1811284375 | Nathan Yennumi Tonlaar | Radiology | 2055 S Fremont Ave, Mercy Clinic Radiation Oncology, Chaub O'reilly Center, Springfield, MO 65804-2206 | 2011-07-06 |
| 1720378862 | Andria Marie Gibb | Physician Assistant | 2055 S Fremont Ave, Springfield, MO 65804-2206 | 2011-04-11 |
| 1073824553 | Christopher Fleighton Estes | Radiology | 2055 S Fremont Ave, Springfield, MO 65804-2206 | 2010-06-29 |
| 1740506419 | Logan B Lackey II | Radiology | 2055 S Fremont Ave, Suite 120, Springfield, MO 65804-2206 | 2010-04-20 |
| 1194041855 | Amanda Elizabeth Lackey | Radiology | 2055 S Fremont Ave, Suite 120, Springfield, MO 65804-2206 | 2010-04-20 |
| 1730329640 | Stephanie L Ledl | Nurse Practitioner | 2055 S Fremont Ave, Suite 1000, Springfield, MO 65804-2206 | 2009-03-05 |
| 1558568618 | Kimberly M Creach | Radiology | 2055 S Fremont Ave, Springfield, MO 65804-2206 | 2007-06-29 |
| 1477760437 | Jessica Nicole Snider | Internal Medicine | 2055 S Fremont Ave, Suite 1000, Springfield, MO 65804-2206 | 2007-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| 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 |
|---|---|---|---|---|
| 1912347519 | Erica Weston | Obstetrics & Gynecology | 3300 Main St, Springfield, MA 01107-1112 | 2013-06-27 |
| 1376803148 | Lindsay Morgan West | Obstetrics & Gynecology | 3300 Main Street, 4th Floor, Springfield, MA 01107-1112 | 2012-05-25 |
| 1043338395 | Nora Taylor Maczura | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2007-03-26 |
| 1902931587 | Kathleen Ying Yang | Obstetrics & Gynecology | 3377 Riverbend Dr Ste 500, Springfield, OR 97477-8802 | 2007-02-22 |
| 1902990260 | John C. Shaffer | Obstetrics & Gynecology | 800 N. 1st Street, Springfield, IL 62702 | 2006-10-03 |
| 1598859324 | Michel Prefontaine | Obstetrics & Gynecology | 3350 Main St, Springfield, MA 01199-1005 | 2006-10-03 |
| 1821103912 | Tashanna K Myers | Obstetrics & Gynecology | 3350 Main St, 4th Fl, Springfield, MA 01107-1112 | 2006-08-20 |
| 1063437127 | Audrey Garrett | Obstetrics & Gynecology | 3355 Riverbend Dr, Ste 210, Springfield, OR 97477-8800 | 2006-07-12 |
| 1740212232 | Deborah J Dotters | Obstetrics & Gynecology | 3355 Riverbend Dr, Ste 210, Springfield, OR 97477-8800 | 2006-07-07 |
| 1346278041 | Laurent Brard | Obstetrics & Gynecology | 415 N 9th St, Ste 6w70, Springfield, IL 62702-5303 | 2006-06-29 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.