Active NPI
Steven Kent Nelson, DMD
- Prosthodontics
- Augusta, GA
National Provider Identifier
1003861352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DNF000247
- Practice address
- 1459 Laney Walker Blvd
Ad1501
Augusta, GA 30912-0002 - Phone
- (706) 721-0502
- Fax
- (706) 721-6778
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DNF000247 | GA | Primary |
Addresses
Primary practice location
1459 Laney Walker Blvd
Ad1501
Augusta, GA 30912-0002
Mailing address
1459 Laney Walker Blvd
Ad1501
Augusta, GA 30912-0002
Phone (706) 721-0502
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZG0247 | Medicaid | SC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DNF000247 | GA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1003861352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1459 LANEY WALKER BLVD",
"address_2": "AD1501",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120002",
"telephone_number": "706-721-0502",
"fax_number": "706-721-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 LANEY WALKER BLVD",
"address_2": "AD1501",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120002",
"telephone_number": "706-721-0502",
"fax_number": "706-721-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "STEVEN",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "GA",
"license": "DNF000247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZG0247",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.