GEOFFREY CARLSON (NPI# 1417990904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417990904 |
| Entity Type | Individual |
| Full Name | GEOFFREY CARLSON |
| Credential | PA |
| Practice Address |
11 Ingot Dr Blandon PA 19510-9639 |
| Mailing Address |
Po Box 783311 Philadelphia PA 19178-3311 |
| Practice Telephone | 6109445555 |
| Practice Fax Number | 6109445551 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-12-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
OA000359L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518968213 | Geoffrey Peter Carlson | Optometrist | 2200 5th Ave, Oroville, CA 95965-5816 | 2005-08-03 |
| 1174865588 | Geoffrey S Carlson | Internal Medicine | 4105 Briargate Pkwy Ste 125, Colorado Springs, CO 80920-3482 | 2013-03-24 |
| Street Address |
11 INGOT DR |
| City | BLANDON |
| State | PA |
| Zip Code | 19510-9639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990080 | Jin Xu | Family Medicine | 11 Ingot Dr, Blandon, PA 19510-9639 | 2006-04-11 |
| 1689889990 | Marianne T Adam | Nurse Practitioner | 11 Ingot Dr, Blandon, PA 19510-9639 | 2007-05-11 |
| 1376591404 | Robert S Donovan | Family Medicine | 11 Ingot Dr, Blandon, PA 19510-9639 | 2006-05-04 |
| 1942265376 | Berks Family Physicians, P.C. | Family Medicine | 11 Ingot Dr, Blandon, PA 19510-9639 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043420623 | Monica Diane Schick | Dentist | 108 Plaza Dr, Suite 102, Blandon, PA 19510 | 2007-05-23 |
| 1326533209 | Christina Weaver Farrell | Dentist | 109 Anna Ave, Blandon, PA 19510 | 2018-06-24 |
| 1366757973 | St. Joseph Regional Health Network | Clinic/Center | 108 Plaza Dr, Suite 101, Blandon, PA 19510 | 2010-08-09 |
| 1902045255 | Blandon Pharmacy LLC | Pharmacy | 104 Anna Ave, Blandon, PA 19510-9310 | 2009-02-10 |
| 1881659829 | Michael S Shuman | Dentist | 109 Anna Ave, Blandon, PA 19510-9311 | 2006-04-20 |
| 1578125639 | Brent Andrew Valosin | Dentist | 109 Anna Ave, Blandon, PA 19510-9311 | 2019-06-28 |
| 1407205370 | Matthew J Cambria | Dentist | 109 Anna Ave, Blandon, PA 19510-9311 | 2016-06-10 |
| 1831139914 | Brian Mark Schwab | Dentist | 109 Anna Ave, Blandon, PA 19510-9311 | 2006-06-07 |
| 1679028898 | Joseph Dantas | Pharmacist | 104 Anna Ave, Blandon, PA 19510-9317 | 2016-08-17 |
| 1699181172 | Michael Lloyd | Physician Assistant | 108 Plaza Dr Ste 100, Blandon, PA 19510-9454 | 2014-07-07 |
| Find all providers in zip 19510 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699181172 | Michael Lloyd | Physician Assistant | 108 Plaza Dr Ste 100, Blandon, PA 19510-9454 | 2014-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355341 | Julia Majewicz Wilson | Physician Assistant | 111 Pa-715, #102, Brodheadsville, PA 18322 | 2020-10-29 |
| 1417557273 | Jared Michael Yon | Physician Assistant | 902 Dale Ave, Bradfordwoods, PA 15015-1236 | 2020-10-29 |
| 1295335230 | Jillian Ann Korgeski | Physician Assistant | 400 Corner St, Dunmore, PA 18512-2348 | 2020-10-29 |
| 1821697376 | Sidney Patel | Physician Assistant | 1834 Oregon Pike Ste 20, Lancaster, PA 17601-6463 | 2020-10-25 |
| 1629677356 | Jason Christopher Takacs Jr. | Physician Assistant | 510 Stockton Rdg, Cranberry Township, PA 16066-2280 | 2020-10-23 |
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1508465840 | Tran Quyen Tran | Physician Assistant | 2941 Hillside Rd, Broomall, PA 19008-1304 | 2020-10-19 |
| 1275132656 | Jessica Haley Stecklein | Physician Assistant | 696 Fir Ave, Langhorne, PA 19047-5450 | 2020-10-18 |
| 1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
| 1386251619 | Nicholas James Lazorka | Physician Assistant | 195 Chapmans Round Top Rd, Montoursville, PA 17754-7508 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.