Cory Nelson, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

8591638-1204 Issued in UT

Practice address

3401 N Center St Ste 100
Lehi, UT 84043-7498

Phone

(801) 753-7770

Fax

(801) 753-7775

NPI assigned

Jul 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Sports Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed Associates LLCGroup PAC ID 6204140122, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Sportsmed Associates LLC

  • Sports Medicine (Family Medicine) Physician
  • Lehi, UT
  • NPI 1285013987
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Provo, UT
  • NPI 1649304445
  NPD (past)
• Ihc Health Services Inc

  • Orthopaedic Surgery Physician
  • Provo, UT
  • NPI 1750415840
  NPD (past)
• Interventional Spine & Pain Management

  • Pain Medicine Physician
  • Ogden, UT
  • NPI 1992342414
  NPD (past)

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1124339460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N CENTER ST STE 100",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437498",
            "telephone_number": "801-753-7770",
            "fax_number": "801-753-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CENTER ST STE 100",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437498",
            "telephone_number": "801-753-7770",
            "fax_number": "801-753-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3943 E Pony Express Pkwy Ste 210",
            "address_purpose": "LOCATION",
            "city": "Eagle Mountain",
            "state": "UT",
            "postal_code": "840055544",
            "country_code": "US",
            "telephone_number": "801-789-3030",
            "fax_number": "801-789-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CORY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "8591638-1204",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101018672",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "UT",
            "license": "8591638-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cory.nelson@direct.imail.org",
            "affiliation": "N",
            "address_1": "3401 N Center St Ste 100",
            "city": "Lehi",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840437498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dakota Kelly Naegle, PHARMD
• National Birth Centers Inc
• Tezz Lee Naylor, CSW
• NBL Mobile TX, PLLC
• Heidianne Neilsen
• Emily Caroline Nelson, NP
• Jackie Marie Nelson, PSY.D.
• Jess Thad Nelson, M.D.
• Mary Jane Nelson, LCSW
• Timothy Nelson, PHARMD

• Sports Medicine (Family Medicine) Physician in Lehi, UT
• Providers in Lehi, UT by specialty
• Sports Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.

Verify at the official NPI Registry.