Joe R Nielsen MD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

178171-1205 Issued in UT

Legal business name

JOE R NIELSEN MD PC

Practice address

415 Medical Dr
D-200
Bountiful, UT 84010-4946

Phone

(801) 292-6277

Fax

(801) 292-1108

NPI assigned

Nov 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Joe R Nielsen, MDNPI 1992766885

Title

President

Phone

(801) 292-6277

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joe Roth Nielsen, M.D.

  • Specialist
  • Bountiful, UT
  • NPI 1992766885
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1164723482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR",
            "address_2": "D-200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-292-6277",
            "fax_number": "801-292-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR",
            "address_2": "D-200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-292-6277",
            "fax_number": "801-292-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE R NIELSEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-292-6277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "UT",
            "license": "178171-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tenille Jensen
• Vera Anna Jensen
• Sara Nicole Jeppson
• Meiqi Jiang
• Jim Bradway MD PC
• Veronica Maria Jofre
• John B Lyman MD PC
• John C. Edwards MD Inc.
• Colin Johns-Hegerhorst
• Adam Duane Johnson, APRN

• Clinic/Center in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.