John Anthony Nanson, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20112 Issued in IA

Practice address

1607 E 33Rd St
Ellefson Free Clinic
Des Moines, IA 50317-2705

Phone

(515) 266-7622

NPI assigned

Aug 10, 2007

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

Enrolled in AZ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1104018415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 S SUNDOWN RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863035105",
            "telephone_number": "928-777-9155",
            "fax_number": "928-778-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E 33RD ST",
            "address_2": "ELLEFSON FREE CLINIC",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503172705",
            "telephone_number": "515-266-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANSON",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IA",
            "license": "20112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Duangchai Narawong, MD
• Scott M Nash, MSW, LISW
• Amar Nath, M.D.
• Robert M Nathanson, DO
• National Vision, Inc.

• General Practice Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• General Practice Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.