NPIMap

Individual provider Active NPI

Robert W. Nelson, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Scottsbluff, NE
National Provider Identifier
1083931877
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1157 Issued in NE
Practice address
3911 Avenue B
Suite 2300
Scottsbluff, NE 69361-4617
Phone
(308) 630-1055
Fax
(308) 630-2060
NPI assigned
May 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X P4602 TX
Physical Medicine & Rehabilitation Physician 208100000X 1157 NE Primary

Addresses

Primary practice location

3911 Avenue B
Suite 2300
Scottsbluff, NE 69361-4617

Mailing address

3911 Avenue B
Suite 2300
Scottsbluff, NE 69361-4617
Phone (308) 630-1055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190412002191 SD Practitioner - Physical Medicine and Rehabilitation 5890928162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Arizona College of Osteopathic Medicine Mid Western University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

677 Cathedral Dr
Suite 310
Rapid City, SD 57701-6018
Phone (605) 755-6720

Hospital & facility affiliations

  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Rehab & Critical Care Hospital of the Black Hills Inpatient rehabilitation facility, Rapid City, SD, CCN 43TA03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1157NEMDChiropractor
P4602TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Mar 13, 2019 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Mar 13, 2019 Accepting new patients
Rehabilitation and Critical Care Hospital of the Black Hills, LLC Past Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

2929 5th St
Ste 240250
Rapid City, SD 57701

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Organizations & group practices 5

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1083931877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B",
            "address_2": "SUITE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-630-1055",
            "fax_number": "308-630-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B",
            "address_2": "SUITE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-630-1055",
            "fax_number": "308-630-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROBERT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "P4602",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NE",
            "license": "1157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

Verify at the official NPI Registry.