Jay Woodworth Nelson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1339 Issued in WA

Practice address

625 Black Lake Blvd SW
Olympia, WA 98502-5066

Phone

(360) 943-2334

Fax

(360) 943-2879

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Usv Optical Inc.

  • Eyewear Supplier
  • Olympia, WA
  • NPI 1184645251
  NPD (past)
• Usv Optical Inc

  • Eyewear Supplier
  • Blackwood, NJ
  • NPI 1578891008

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073674230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025066",
            "telephone_number": "360-943-2334",
            "fax_number": "360-943-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BLACK LAKE BLVD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025066",
            "telephone_number": "360-943-2334",
            "fax_number": "360-943-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JAY",
        "middle_name": "WOODWORTH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neighborhood Physical Therapy PLLC
• Travis Colin Nellor
• Ashley Nicole-Kirley Nelson, LMFT
• Braden Kyle Nelson, DO
• Heather Nelson, OT
• Kess Kintla Nelson
• Nancy P Nelson, ARNP
• Makenna Elizabeth Nero
• Trista Lynn Nesbit-Evans, MA00018619
• David Nesheim, MD

• Optometrist in Olympia, WA
• Providers in Olympia, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.