Individual provider Active NPI

Deanne Rene Nelson, FNP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1033876099
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5015467 Issued in NC
Practice address
125 Queens Rd Ste 520
Charlotte, NC 28204-3215
Phone
(980) 302-6500
Fax
(980) 302-6505
NPI assigned
Nov 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219940 NC
Nurse Practitioner 363L00000X 5015467 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 520
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dnelson79592@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220211002147 NC Practitioner - Nurse Practitioner 7517350655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Suite 520
Charlotte, NC 28204-3215
Phone (980) 302-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5015467NCMDNurse Practitioner
219940NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Jan 27, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 27, 2022 Accepting new patients
The Presbyterian Hospital CurrentSince Jan 27, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 27, 2022 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Ste 640
Charlotte, NC 28204
Phone (980) 302-6761

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

125 Queens Rd
Ste 520
Charlotte, NC 28204
Phone (980) 302-6500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: dnelson79592@direct.novanthealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1033876099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 520",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "980-302-6500",
            "fax_number": "980-302-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DEANNE",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "219940",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnelson79592@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 520",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.