Individual provider Active NPI

Karl A. Nielson, DO

  • Occupational Medicine Physician
  • Robins Afb, GA
National Provider Identifier
1144885658
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
13007622-1204 Issued in UT
Practice address
655 7TH St
Robins Afb, GA 31098-2227
Phone
(478) 327-8487
NPI assigned
May 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 0102206324 VA
General Practice Physician 208D00000X 0102206324 VA
Occupational Medicine Physician 2083X0100X 13007622-1204 UT Primary

Addresses

Primary practice location

655 7TH St
Robins Afb, GA 31098-2227

Mailing address

655 7TH St
Robins Afb, GA 31098-2227
Phone (478) 327-8487

Other practice location 1

3458 Neely Rd
Jb Mdl, NJ 08641-5312
Phone (609) 754-9385

Other practice location 2

Travis AFB
Fairfield, CA
Apo, AA 94535
Phone (707) 423-5180

Other practice location 3

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (707) 423-5180

Other practice location 4

250 E 200 S Rm 1202
Salt Lake City, UT 84111-2472
Phone (801) 581-3841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206324VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1144885658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3458 Neely Rd",
            "address_purpose": "LOCATION",
            "city": "Jb Mdl",
            "state": "NJ",
            "postal_code": "086415312",
            "country_code": "US",
            "telephone_number": "609-754-9385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Travis AFB",
            "address_2": "Fairfield, CA",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AA",
            "postal_code": "94535",
            "country_code": "US",
            "telephone_number": "707-423-5180",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "707-423-5180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 E 200 S Rm 1202",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841112472",
            "country_code": "US",
            "telephone_number": "801-581-3841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "KARL",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "0102206324",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102206324",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "UT",
            "license": "13007622-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robins Afb, GA

Sources for this page

Verify at the official NPI Registry.