Adam Phillip Nelson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G68858 Issued in CA

Practice address

45 Camino Alto
Suite 200
Mill Valley, CA 94941-2929

Phone

(415) 460-6710

Fax

(415) 460-6710

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 4, 2015 through Aug 4, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• La Cheim School, Inc.

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1275881492
  NPD (past) Authorized official
• La Cheim School, Inc.

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1831289347
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1124032230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CORTE MADERA TOWN CTR",
            "address_2": "PMB 594",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251209",
            "telephone_number": "415-460-6710",
            "fax_number": "415-460-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CAMINO ALTO",
            "address_2": "SUITE 200",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412929",
            "telephone_number": "415-460-6710",
            "fax_number": "415-460-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3031 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093205",
            "country_code": "US",
            "telephone_number": "510-596-8125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ADAM",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G68858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G688581",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Bradley Morris, DDS
• Lisa Murphy, MSW, LCSW
• Nora Heins Murray, PSYD
• Myrdhap in-Home Dental Hygiene Practice of Mahnaz Tayarani Rdhap
• Jeffrey Nebenzahl, DDS
• Barbara Elizabeth Nelson, M.F.T.
• Jamie Marie-Stager Nelson, DPT
• Lee Scott Nelson, LMFT
• Mary Grover Newcomer
• Barbara Newlon, D.O.

• Psychiatry Physician in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.