Active NPI
Derek Dee Nelson, D.C.
- Chiropractor
- Fort Worth, TX
National Provider Identifier
1124487640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13155
- Practice address
- 3625 Western Center Blvd
Fort Worth, TX 76137-1936 - Phone
- (817) 498-7333
- Fax
- (817) 581-2866
- NPI assigned
- Feb 11, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13155 | TX | Primary |
Addresses
Primary practice location
3625 Western Center Blvd
Fort Worth, TX 76137-1936
Mailing address
PO Box 48370
Fort Worth, TX 76148-0370
Phone (817) 498-7333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13155 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455148800000",
"number": "1124487640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 48370",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761480370",
"telephone_number": "817-498-7333",
"fax_number": "817-581-2866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 WESTERN CENTER BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761371936",
"telephone_number": "817-498-7333",
"fax_number": "817-581-2866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "DEREK",
"middle_name": "DEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-11",
"last_updated": "2016-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.