Shaun Nelson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA842 Issued in KY

Practice address

120 Executive Park
Louisville, KY 40207-4201

Phone

(502) 855-7200

Fax

(502) 855-7201

NPI assigned

Sep 12, 2005

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment Care Compare group NPD
• Commonwealth Pain Associates, PLLC

  dba Commonwealth Pain and Spine

  • Interventional Pain Medicine Physician
  • Louisville, KY
  • NPI 1306280177
  Medicare reassignment
• Wellington Provider Group PC

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1457012205

  Physician Assistant

  NPD
• Baptist Health Medical Group, Inc.

  • Family Medicine Physician
  • Jeffersonville, IN
  • NPI 1811648827

  Physician Assistant

  NPD
• Pain Control Network, PSC

  • Pain Clinic/Center
  • Louisville, KY
  • NPI 1467447961
  NPD (past)
• PCN Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Louisville, KY
  • NPI 1952396467
  NPD (past)

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

• Baptist Healthcare System Inc.

  dba Baptist Health Louisville

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1265539498
  Care Compare affiliation

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1104811603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074202",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074201",
            "telephone_number": "502-855-7200",
            "fax_number": "502-855-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Wellington Way Ste 330",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405031331",
            "country_code": "US",
            "telephone_number": "859-439-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHAUN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040820",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95004735",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER",
            "identifier": "100508KYIP",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF KY PROVIDER ID NUMBER",
            "identifier": "2268718",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID NUMBER",
            "identifier": "000001408313",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE PROVIDER ID NUMBER",
            "identifier": "CS2026900168",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige C. Nelson, APRN
• Pamela Nelson
• Rayna L. Nelson, LCSW
• Reid Arthur Nelson, DMD
• Shanice Nelson
• Stacey Nelson
• Steffanie Nicole Nelson
• Wyatt Andrew Nelson
• Gabor G Nemeth, M.D.
• George Winston Nemeth, MPH

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.