Individual provider Active NPI

Timothy N Nelson, LAC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1083955694
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC161759 Issued in OR
Practice address
2917 NE Everett St
Portland, OR 97232-3248
Phone
(971) 227-2773
NPI assigned
Mar 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC161759 OR Primary

Addresses

Primary practice location

2917 NE Everett St
Portland, OR 97232-3248

Mailing address

8034 NE Holladay St Unit B
Portland, OR 97213-6871
Phone (971) 227-2773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC161759ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1083955694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8034 NE HOLLADAY ST UNIT B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136871",
            "telephone_number": "971-227-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 NE EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323248",
            "telephone_number": "971-227-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TIMOTHY",
        "middle_name": "N",
        "credential": "LAC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC161759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.