Paul Douglas Nielson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101261500 Issued in VA

Practice address

105 Bona Vista LN
Galax, VA 24333-3605

Phone

(808) 457-2570

NPI assigned

Aug 31, 2006

Last updated

Sep 4, 2023By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in UT, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.nielson@ahml-va.direct.office.nextgen.com
• Direct secure messaging: pnielson@twd-ut.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Innovation Medical Group PC

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  • NPI 1235526682
  Medicare reassignment
• Taylor G Wright PC

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  • Meridian, ID
  • NPI 1366149304
  NPD
• Taylor G Wright PC

  dba Innovation Medical Group

  • Podiatrist
  • Layton, UT
  • NPI 1528765575
  NPD (past)
• Taylor G Wright PC

  dba Innovation Medical Group

  • Podiatrist
  • St George, UT
  • NPI 1700583754

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1114039070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BONA VISTA LN",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333605",
            "telephone_number": "808-457-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BONA VISTA LN",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333605",
            "telephone_number": "808-457-2570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 E 700 S Ste 105",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847904084",
            "country_code": "US",
            "telephone_number": "435-775-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "PAUL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101261500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013331-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca C Neal, LPTA
• Sandy Nester, LPN
• Daniel Neubrander, DPT
• New River Nutrition Services, LLC
• Tonia Newman, RN
• NMG Affiliate Practice I LLC (Novant Health Heart and Vascular)
• Garrick Norman, LPTA
• Novant Medical Group, Inc (Novant Health Cardiology Galax)
• Susan Frances O'Connor, DDS
• Oldtown Medical Care, LLC

• Family Medicine Physician in Galax, VA
• Providers in Galax, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.