Tina Nelson MD & Associates LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TINA NELSON MD & ASSOCIATES LLC

Practice address

3477 Commerce Pkwy
Suite a
Wooster, OH 44691-7126

Phone

(330) 345-8410

Fax

(330) 345-8458

NPI assigned

Jan 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russell W Nelson

Title

Business Manager

Phone

(330) 345-8410

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family 1st Healthcare, LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1003092495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3477 COMMERCE PKWY",
            "address_2": "SUITE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917126",
            "telephone_number": "330-345-8410",
            "fax_number": "330-345-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3477 COMMERCE PKWY",
            "address_2": "SUITE A",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917126",
            "telephone_number": "330-345-8410",
            "fax_number": "330-345-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINA NELSON MD & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "330-345-8410"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2247732",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family 1st Healthcare, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Tickton, CRNP
• Carissa Janel Timko, QMHS
• Holly Ann Timmons
• Tami N. Timmons, LSW
• Timothy D Bowman
• Jane Aikman Tipton, MSW, LISW-S
• Lee Tish
• Paul A Tish, QMHS
• Karra L Todd-Partridge, QMHS-M
• Jonathan T Tolbert, LPCC

• Family Medicine Physician in Wooster, OH
• Providers in Wooster, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.