NPIMap

Organization Active NPI

James M. Nelson, O.D.

  • Eyewear Supplier
  • Muskogee, OK
National Provider Identifier
1114103553
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
2019 Issued in OK
Legal business name
JAMES M. NELSON, O.D.
Practice address
817 Callahan St
Muskogee, OK 74403-5146
Phone
(918) 683-1021
Fax
(918) 683-3347
NPI assigned
Jan 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Authorized official

Name
Dr. James M. Nelson, O.D.
Title
Owner/Optometrist
Phone
(918) 683-1021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 2019 OK Primary

Addresses

Primary practice location

817 Callahan St
Muskogee, OK 74403-5146

Mailing address

817 Callahan St
Muskogee, OK 74403-5146
Phone (918) 683-1021

Other identifiers 1

IdentifierTypeStateIssuer
100765570AMedicaidOK

National Provider Directory

National Provider Directory

Locations

817 Callahan St
Muskogee, OK 74403
Phone (918) 683-1021

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1114103553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CALLAHAN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035146",
            "telephone_number": "918-683-1021",
            "fax_number": "918-683-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 CALLAHAN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035146",
            "telephone_number": "918-683-1021",
            "fax_number": "918-683-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES M. NELSON, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "918-683-1021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "2019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765570A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.