Jakob James Nelson, MA, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2007011137 Issued in MO

Practice address

300 W 19TH Ter
Kansas City, MO 64108-2026

Phone

(816) 404-6295

Fax

(816) 404-6318

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Missouri, Kansas City, School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jakob.nelson@direct.tmcmed.org

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.

• Mindful Journey Psychological Services LLC

  • Clinical Psychologist
  • Kansas City, MO
  • NPI 1750096343
  Medicare reassignment NPD Authorized official
• Truman Medical Center, Incorporated

  • Otolaryngology Physician
  • Kansas City, MO
  • NPI 1184893224
  NPD (past)
• Truman Medical Centers, Inc.

  • Home Health Agency
  • Kansas City, MO
  • NPI 1487797759
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1043353717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 CHARLOTTE ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641101548",
            "telephone_number": "816-531-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 19TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082026",
            "telephone_number": "816-404-6295",
            "fax_number": "816-404-6318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082677",
            "country_code": "US",
            "telephone_number": "816-404-1587",
            "fax_number": "816-404-1519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JAKOB",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MA, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2007011137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490205101",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Nelson, APRN, CPNP-PC
• Elana Marie Nelson, PHARMD
• Emma Katherine Nelson, RD, LDN, CPT
• Erin Renee Nelson, LPN
• Florese Marie Nelson
• John William Nelson Jr., D.D.S., M.P.A.
• Laura L Nelson, CRNA
• Leigh A Nelson, PHARMD
• Lisa Nelson
• Lynne A Nelson, NP

• Psychologist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.