Jeremiah Nelson, MD
Individual provider Active NPI Pediatric Endocrinology Physician · Las Vegas, NV
NPI 1063494524 · NPPES record last updated Sep 18, 2023
Key facts
- NPI
- 1063494524
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Endocrinology Physician 2080P0205X
- License
- 23921 (NV)
- Practice address
- 2880 N Tenaya Way Ste 320
Las Vegas, NV 89128-0642 - Phone
- (702) 862-8226
- Fax
- (702) 862-8227
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- University of Missouri, Kansas City, School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Intermountain Medical Holdings Nevada Inc
Practice addresses (Care Compare)
2880 N Tenaya Way
Suite 320
Las Vegas, NV 89128-0642
Phone (702) 862-8226
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181015003026 | IA | Practitioner - Endocrinology | 4486673548 | Reassigns benefits to 1 organization |
| I20230809001224 | NV | Practitioner - Endocrinology | 4486673548 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 92825 | FL | MD | Endocrinology, Diabetes & Metabolism Physician |
| MD-45607 | IA | MD | Endocrinology, Diabetes & Metabolism Physician |
| 35099088 | OH | MD | Pediatrics Physician |
| ME0092825 | FL | MD | Pediatric Endocrinology Physician |
| 23921 | NV | MD | Pediatric Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Holdings Nevada Inc | Endocrinology, Diabetes & Metabolism | Current |
Accepting new patients |
| North Iowa Mercy Clinics | Current |
Accepting new patients | |
| North Iowa Mercy Clinics | Endocrinology, Diabetes & Metabolism | Current |
Accepting new patients |
| Intermountain Medical Holdings Nevada Inc | Current |
Accepting new patients | |
| North Iowa Mercy Clinics | Current | Accepting new patients | |
| Healthcare Partners Medical Group (Coats) LTD. | Pediatrics | Past | Accepting new patients |
| University Medical Associates Inc. | Past | Accepting new patients | |
| North Iowa Mercy Clinics | Past | Accepting new patients | |
| Florida Health Sciences Center Inc | Endocrinology, Diabetes & Metabolism | Past | Accepting new patients |
| Johns Hopkins All Children'S Hospital, Inc | Past | Accepting new patients |
Locations
1000 4th St SW
Mason City, IA 50401
Phone (641) 424-6704
910 N Eisenhower Ave
Mason City, IA 50401
Phone (641) 422-5437
6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881
2880 N Tenaya Way
Ste 320
Las Vegas, NV 89128
Phone (702) 862-8226
4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554
1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500
Interoperability endpoints
- jeremiahnelson@hcpnv.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | ME 92825 | FL | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | MD-45607 | IA | |
| Pediatrics Physician | 208000000X | 35099088 | OH | |
| Pediatric Endocrinology Physician | 2080P0205X | ME0092825 | FL | |
| Pediatric Endocrinology Physician | 2080P0205X | 35099088 | OH | |
| Pediatric Endocrinology Physician | 2080P0205X | 23921 | NV | Yes |
Addresses
Primary practice location
2880 N Tenaya Way Ste 320
Las Vegas, NV 89128-0642
Mailing address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346
Other practice location 1
615 E Princeton St Ste 101
Orlando, FL 32803-1435
Phone (407) 896-2901
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 297631 | Other | FL | AMERIGROUP |
| 2438274001 | Other | FL | CIGNA |
| 297105 | Other | FL | STAYWELL HEALTHY KIDS |
| 489063073 | Other | FL | HUMANA |
| 7134730 | Other | FL | AETNA UNITED |
| 16865 | Other | FL | BCBS |
Other providers in Las Vegas, NV
- Hayley Lynn Nelson
- Howard Demetris Nelson
- Irene Nelson
- James Nelson Jr.
- Jazzmere Nelson
- John Edward Nelson
- Johnny Nelson
- Jordan W Nelson
- Joshua Nelson
- Karen B Nelson
All providers in Las Vegas, NV · Pediatric Endocrinology Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.