Carmen Nelson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12147370 Issued in IL

Practice address

8 Evergreen Cir
Dekalb, IL 60115-2214

Phone

(773) 217-4907

NPI assigned

Aug 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pyramid Behavioral Health Inc

  • Behavior Analyst
  • Dekalb, IL
  • NPI 1083281851
  NPD

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1104593110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S FORDHAM AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064805",
            "telephone_number": "630-664-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 EVERGREEN CIR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152214",
            "telephone_number": "773-217-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CARMEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "12147370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnelson@pbhe.org",
            "affiliation": "Y",
            "affiliationName": "PYRAMID BEHAVIORAL HEALTH INC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8 Evergreen Cir",
            "city": "Dekalb",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601152214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Syed Najeemuddin, MD
• Rebecca Anne Nates
• Nayna Navik, M.D.
• Hina Nawab, M.D.
• Cynthia Negrete
• Michael Raymond Nelson
• Mark A. Nessim, M.D.
• Aaron J Nevdal, PT
• New Path Therapy and Consulting, PLLC
• Raya Newman

• All providers in Dekalb, IL
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.