Active NPI
Nelson Lee Nagle, L.P.C.
- Mental Health Counselor
- Round Rock, TX
National Provider Identifier
1093825366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12824
- Practice address
- 400 W Main Ave
Suite #106
Round Rock, TX 78664-5808 - Phone
- (512) 218-8538
- Fax
- (512) 218-1821
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12824 | TX | Primary |
Addresses
Primary practice location
400 W Main Ave
Suite #106
Round Rock, TX 78664-5808
Mailing address
400 W Main Ave
Suite #106
Round Rock, TX 78664-5808
Phone (512) 218-8538
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3067LC | Other | TX | BLUE CROSS BLUE SHIELD |
| 10011768 | Other | TX | AMERIGROUP |
| 160750 | Other | TX | VALUE OPTIONS |
| 5405068 | Other | TX | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12824 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093825366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W MAIN AVE",
"address_2": "SUITE #106",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786645808",
"telephone_number": "512-218-8538",
"fax_number": "512-218-1821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W MAIN AVE",
"address_2": "SUITE #106",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786645808",
"telephone_number": "512-218-8538",
"fax_number": "512-218-1821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGLE",
"first_name": "NELSON",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "12824",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3067LC",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10011768",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "160750",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5405068",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- 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.