Active NPI
Robert Nelson, PH.D.
- Speech-Language Pathologist
- Palm Desert, CA
National Provider Identifier
1003056870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 3204
- Practice address
- 38620 Desert Mirage Dr
Palm Desert, CA 92260-0606 - Phone
- (760) 776-0060
- NPI assigned
- Mar 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU 626 | CA | |
| Speech-Language Pathologist | 235Z00000X | SP 3204 | CA | Primary |
Addresses
Primary practice location
38620 Desert Mirage Dr
Palm Desert, CA 92260-0606
Mailing address
38620 Desert Mirage Dr
Palm Desert, CA 92260-0606
Phone (760) 776-0060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU 626 | CA | MD | Audiologist |
| SP 3204 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236211200000",
"number": "1003056870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38620 DESERT MIRAGE DR",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922600606",
"telephone_number": "760-776-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38620 DESERT MIRAGE DR",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922600606",
"telephone_number": "760-776-0060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-05",
"last_updated": "2009-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU 626",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 3204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.