Glenn E. Nelson, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0310 Issued in AZ

Practice address

2308 N Rosemont Blvd
Tucson, AZ 85712-2139

Phone

(520) 886-1176

Fax

(520) 290-8894

NPI assigned

Oct 4, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Barton S. Fink DPM LLC

  • Podiatrist
  • Tucson, AZ
  • NPI 1538274683
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1104813237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 N ROSEMONT BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122139",
            "telephone_number": "520-886-1176",
            "fax_number": "520-290-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 N ROSEMONT BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122139",
            "telephone_number": "520-886-1176",
            "fax_number": "520-290-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GLENN",
        "middle_name": "E.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00198920",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "701004",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chase Nelson, MD
• Craig E Nelson, MD
• Diane T Nelson, R.PH.
• Eric J Nelson, MSPT
• Erin Nicole Nelson, LPC
• Gloriajean Nelson, FNP-C, CWOCN
• Haven Nichole Nelson
• Jan M Nelson, PT, MSPT
• Jeffrey M Nelson, M.D.
• Jessica Anne Nelson, MD

• Foot & Ankle Surgery Podiatrist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.