GARY J. CARLSON (NPI# 1487621876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487621876 |
| Entity Type | Individual |
| Full Name | GARY J. CARLSON |
| Credential | MD |
| Practice Address |
6401 France Ave S Edina MN 55435-2104 |
| Practice Telephone | 9529245000 |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2008-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
26709 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770545709 | Gary R Carlson | Family Medicine | 2833 Chicago Ave. South, Minneapolis, MN 55407-3799 | 2006-04-05 |
| 1508318403 | Gary Carlson | Counselor | 10770 N 46th St, Tampa, FL 33617-3442 | 2016-10-27 |
| 1376609412 | Gary Leroy Carlson | Dentist | 17809 Hutchins Dr, Ste 101, Minnetonka, MN 55345-4100 | 2006-12-30 |
| 1013018217 | Gary S Carlson | Physical Therapist | 2125 Northpoint Blvd, Hixson, TN 37343-4072 | 2006-09-26 |
| 1497700116 | Gary Carlson | Internal Medicine | 520 Superior Ave, Suite 220, Newport Beach, CA 92663-3637 | 2006-05-23 |
| 1144280181 | Gary Roy Carlson | Specialist | 1240 S Westlake Blvd, Suite 205, Westlake Village, CA 91361-1929 | 2006-03-24 |
| 1912989864 | Gary L Carlson | Otolaryngology | 2805 5th St, Suite 100, Rapid City, SD 57701-6003 | 2005-11-16 |
| Street Address |
6401 FRANCE AVE S |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162128 | Molly E Martin | Internal Medicine | 6401 France Ave S, Edina, MN 55435 | 2005-05-27 |
| 1760098156 | Tyler William Freiborg | Registered Nurse | 6401 France Ave S, Edina, MN 55435-2104 | 2020-09-21 |
| 1831707207 | Fairview Express Care | General Practice | 6401 France Ave S, Edina, MN 55435-2104 | 2020-07-21 |
| 1255951950 | Jennifer L Guptail | Dietitian, Registered | 6401 France Ave S, Edina, MN 55435-2104 | 2020-04-22 |
| 1053931964 | Emilee Kuehl | Nurse Practitioner | 6401 France Ave S, Edina, MN 55435-2104 | 2020-04-21 |
| 1689211526 | Angela Tullbane | Dietitian, Registered | 6401 France Ave S, Ll10, Edina, MN 55435 | 2019-12-10 |
| 1679119341 | Mckenzie Jo Young | Dietitian, Registered | 6401 France Ave S, Edina, MN 55435-2104 | 2019-11-18 |
| 1629619218 | Sonya Blyakher | Physical Therapist | 6401 France Ave S, Edina, MN 55435-2104 | 2019-10-04 |
| 1386294791 | Michelle Teigen | Nurse Anesthetist, Certified Registered | 6401 France Ave S, Edina, MN 55435-2104 | 2019-09-17 |
| 1134779853 | Vanesha Vasian Gordon-king | Nurse Practitioner | 6401 France Ave S, Edina, MN 55435-2104 | 2019-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
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| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558338947 | Daniel Berntson | Pathology | 6401 France Ave S, Edina, MN 55435-2104 | 2006-03-03 |
| 1285601633 | Bruce C. Trautman | Pathology | 6401 France Ave S, Edina, MN 55435-2104 | 2006-03-03 |
| 1114994563 | Kathrine P. Frey | Pathology | 6401 France Ave S, Edina, MN 55435-2104 | 2006-03-03 |
| 1831166289 | Dale C. Snover | Pathology | 6401 France Ave S, Edina, MN 55435-2104 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255697470 | Xiangrong He | Pathology | Mayo Clinic 200 1st Street Sw, Rochester, MN 55905-0341 | 2012-04-02 |
| 1588989289 | Barbara A Burke | Pathology | 7009 Cheyenne Trail, Chanhassen, MN 55317-7513 | 2010-04-06 |
| 1144457466 | Leah Ann Dvorak | Pathology | 301 Becker Avenue Sw, Willmar, MN 56201-3302 | 2009-06-12 |
| 1437190659 | Glenn Carter Faith | Pathology | 1004 1st St Nw, Rochester, MN 55901-6229 | 2006-06-09 |
| 1003878661 | Three Rivers Pathology Pa | Pathology | 2664 Patton Road, Roseville, MN 55113 | 2006-04-06 |
| 1154305324 | Mark Luquette | Pathology | 500 Harvard St Se Ste 609, Minneapolis, MN 55455-0363 | 2005-12-01 |
| 1922650563 | Matthew Cecchini | Pathology | Mayo Clinic 200 First St Sw, Rochester, MN 55905-0001 | 2019-07-14 |
| 1134681182 | Maria Adelita Vizcaino Villalobos | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2019-04-01 |
| 1376008755 | Oyedele Adeyi | Pathology | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2019-02-09 |
| 1689141335 | Reade Alan Quinton | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-10-31 |
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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.