Individual provider Active NPI

Richard N Nelson, M.D.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1063593879
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35043730 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-8305
Fax
(614) 293-3124
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35043730 OH Primary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 35043730 OH

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd
Suite 570
Columbus, OH 43202-1559
Phone (614) 255-7750

Other identifiers 1

IdentifierTypeStateIssuer
0448340MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001052 OH Practitioner - Emergency Medicine 0143344101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio State University College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Emergency Medicine LLCGroup PAC ID 2668386673, 169 clinicians

Practice addresses (Care Compare)

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8305

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35043730OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Emergency Medicine LLC CurrentSince Dec 31, 1975 Accepting new patients
Osu Observation Medicine, LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

Organizations & group practices 2

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 3

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1063593879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "SUITE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-255-7750",
            "fax_number": "614-262-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-8305",
            "fax_number": "614-293-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RICHARD",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35043730",
            "primary": true
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "OH",
            "license": "35043730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448340",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.