Individual provider Active NPI

Christopher Thomas Nelson, MD

  • Pediatrics Physician
  • Boerne, TX
National Provider Identifier
1164442240
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H9552 Issued in TX
Practice address
124 E Bandera Rd Ste 304
Boerne, TX 78006-2852
Phone
(830) 816-5055
NPI assigned
Jul 20, 2006
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32650 KY
Pediatrics Physician 208000000X H9552 TX Primary
Pediatric Adolescent Medicine Physician 2080A0000X 32650 KY
Pediatric Infectious Diseases Physician 2080P0208X 32650 KY

Addresses

Primary practice location

124 E Bandera Rd Ste 304
Boerne, TX 78006-2852

Mailing address

19238 Stonehue
San Antonio, TX 78258-3447
Phone (210) 494-2223

Other identifiers 1

IdentifierTypeStateIssuer
64326507MedicaidKY

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32650KYMDPediatrics Physician
H9552TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anne D Logan Mdpa Pediatrics PastSince Aug 7, 2022 Accepting new patients
Topcare Medical Group Inc PastSince Aug 7, 2022 Accepting new patients
Abcd Pediatrics Pediatrics PastSince Aug 7, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1164442240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19238 STONEHUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583447",
            "telephone_number": "210-494-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD STE 304",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062852",
            "telephone_number": "830-816-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "32650",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H9552",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "32650",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "KY",
            "license": "32650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64326507",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.