Active NPI
Kirtisha Danielle Nelson
- Surgery Physician
- Downey, CA
National Provider Identifier
1033862537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- F5T6C5G4
- Practice address
- 9449 Imperial Hwy
Downey, CA 90242-2814 - Phone
- (833) 574-2273
- NPI assigned
- Feb 3, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | F5T6C5G4 | FL | Primary |
Addresses
Primary practice location
9449 Imperial Hwy
Downey, CA 90242-2814
Mailing address
10628 Lake Montauk Dr
Riverview, FL 33578-9511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N425504968750 | Other | FL | DRIVER'S LICENSE |
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 |
|---|---|---|---|
| F5T6C5G4 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1033862537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10628 LAKE MONTAUK DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335789511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9449 IMPERIAL HWY",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902422814",
"telephone_number": "833-574-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KIRTISHA",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-03",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "F5T6C5G4",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "N425504968750",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.