Jennifer Nelson

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95009465 Issued in CA

Practice address

7720 N Fresno St
Fresno, CA 93720-2407

Phone

(559) 438-2300

NPI assigned

Sep 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment NPD
• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment NPD
• Valley Children'S Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  NPD (past)

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1043793466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3483 PONTIAC AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936197237",
            "telephone_number": "559-355-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202407",
            "telephone_number": "559-438-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95009465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "95009465",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ciera Nelson
• Dione Nelson, CADC II
• Etroy Nelson
• Gretchen Nelson, FNP-C
• Janet Louise Nelson, CAS II
• Jerry W Nelson, M.D.
• John R Nelson, MD
• Kayleigh K Nelson
• Kimberly Nelson
• Laura A Nelson, LSCSW

• Pediatric Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.