Individual provider Active NPI

John E. Nelson, M.D.

  • Psychiatry Physician
  • Ojai, CA
National Provider Identifier
1083632061
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G19171 Issued in CA
Practice address
530 W Ojai Ave
206
Ojai, CA 93023-2462
Phone
(805) 640-8549
Fax
(805) 640-8624
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G19171 CA Primary

Addresses

Primary practice location

530 W Ojai Ave
206
Ojai, CA 93023-2462

Mailing address

530 W Ojai Ave
206
Ojai, CA 93023-2462
Phone (805) 640-8549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101015001117 CA Practitioner - Psychiatry 3476746975 Practice locations: Ojai, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G19171CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083632061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W OJAI AVE",
            "address_2": "206",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930232462",
            "telephone_number": "805-640-8549",
            "fax_number": "805-640-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W OJAI AVE",
            "address_2": "206",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930232462",
            "telephone_number": "805-640-8549",
            "fax_number": "805-640-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G19171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ojai, CA

Sources for this page

Verify at the official NPI Registry.