Active NPI
Christopher L. Nelson, PA
- Surgical Physician Assistant
- Cookeville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 2974
- Practice address
- 222 W 4TH St Ste 201
Cookeville, TN 38501-2413 - Phone
- (931) 783-4269
- Fax
- (931) 372-0401
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 085000452 | IL | |
| Physician Assistant | 363A00000X | 2974 | TN | |
| Surgical Physician Assistant | 363AS0400X | 085000452 | IL | |
| Surgical Physician Assistant | 363AS0400X | 2974 | TN | Primary |
Addresses
Primary practice location
222 W 4TH St Ste 201
Cookeville, TN 38501-2413
Mailing address
140 W 7TH St
Cookeville, TN 38501-1726
Phone (931) 783-5582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q020561 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-5857
100 W 4TH St
Suite 350
Cookeville, TN 38501-4225
Phone (931) 783-2753
Hospital & facility affiliations
- Cookeville Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2974 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Cardiovascular & Thoracic Surgery, LTD | Cardiovascular Disease | Past | Accepting new patients |
Interoperability endpoints
- christopher.nelson.1@10383.direct.athenahealth.com
- cnelsonmd311087@carlehiedirect.net
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Cookeville, TN
- NPI 1649202102
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Bloomington, IL
- NPI 1962450734
Cardiovascular Disease
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cookeville, TN
- NPI 1275531956
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746057600000",
"number": "1114911971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 W 7TH ST",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385011726",
"telephone_number": "931-783-5582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W 4TH ST STE 201",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012413",
"telephone_number": "931-783-4269",
"fax_number": "931-372-0401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CHRISTOPHER",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2025-05-01",
"certification_date": "2025-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "085000452",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "2974",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": "085000452",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TN",
"license": "2974",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q020561",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.