Individual provider Active NPI

David Nelson, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Burlington, VT
National Provider Identifier
1174663066
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
042.0014336 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-1237
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 338805 NY
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 63616 CT
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 042.0014336 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-3736

Other practice location 1

75 Beekman St
Plattsburgh, NY 12901-1427
Phone (518) 561-2000

Other practice location 2

75 Park St
Elizabethtown, NY 12932
Phone (518) 873-6377

Other practice location 3

133 Park St
Malone, NY 12953-1244
Phone (518) 483-3000

Other identifiers 1

IdentifierTypeStateIssuer
2018320MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190917001530 VT Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8729052329 Reassigns benefits to 1 organization
I20260326000043 NY Practitioner - Emergency Medicine 8729052329 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63616CTMDPediatric Emergency Medicine (Emergency Medicine) Physician
042.0014336VTMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients
Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Clark Pediatrics McCourt, PLLC Emergency Medicine Past Accepting new patients

Locations

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: dnelson235629@direct.uvmhealth.org
  • Direct secure messaging: dnelson10367@direct.umcsn.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1174663066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022329",
            "telephone_number": "702-383-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-1237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011427",
            "country_code": "US",
            "telephone_number": "518-561-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Park St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NY",
            "postal_code": "12932",
            "country_code": "US",
            "telephone_number": "518-873-6377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 Park St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531244",
            "country_code": "US",
            "telephone_number": "518-483-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "338805",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CT",
            "license": "63616",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "VT",
            "license": "042.0014336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018320",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.