Individual provider Active NPI

Erik Leslie Nelson, O.D.

  • Optometrist
  • Lahaina, HI
National Provider Identifier
1134246564
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
111 Issued in HI
Practice address
845 Wainee St
Suite 202
Lahaina, HI 96761-2321
Phone
(808) 661-3686
Fax
(808) 661-3687
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 111 HI Primary

Addresses

Primary practice location

845 Wainee St
Suite 202
Lahaina, HI 96761-2321

Mailing address

845 Wainee St
Suite 202
Lahaina, HI 96761-2321
Phone (808) 661-3686

Other identifiers 1

IdentifierTypeStateIssuer
051490MedicaidHI

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

LicenseStateTypeSpecialty
111HIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134246564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 WAINEE ST",
            "address_2": "SUITE 202",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967612321",
            "telephone_number": "808-661-3686",
            "fax_number": "808-661-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 WAINEE ST",
            "address_2": "SUITE 202",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967612321",
            "telephone_number": "808-661-3686",
            "fax_number": "808-661-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ERIK",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051490",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lahaina, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.