Michelle J Nelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004779 Issued in WA

Practice address

1717 S J St
Tacoma, WA 98405-4933

Phone

(253) 426-6341

Fax

(253) 426-6344

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Michelle Teig Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Terry L Jacobson MD PLLC

  • Internal Medicine Physician
  • Issaquah, WA
  • NPI 1316954506
  Medicare reassignment NPD
• Franciscan Medical Group

  • Neurological Surgery Physician
  • Federal Way, WA
  • NPI 1386857530
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1174620058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELLE",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0195914",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8427197",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8905199",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00294398",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "TEIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Lewis Nelson, MD
• Mark P. Nelson
• Mary Lou Nelson, L.M.P.
• Matthew Douglass Nelson, DDS
• Michael M Nelson, PTA
• Monica Nelson, ARNP
• Paul A Nelson, PH.D.
• Paul Stewart Nelson, M.D.
• Phyllis Nelson, RDH
• Sarah Christine Nelson, M.D.

• Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.