Alan S. Nelson D.O. PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O143 Issued in ID

Legal business name

ALAN S. NELSON D.O. PC

Doing business as

Alan S. Nelson D.O. PC

Practice address

1404 Pomerelle Ave.
Suite A2
Burley, ID 83318-1564

Phone

(208) 878-8817

NPI assigned

Dec 14, 2011

Last updated

Dec 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alan S. Nelson, D.O.

Title

Physician/Owner

Phone

(208) 878-8817

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alan S. Nelson D.O. PC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Jill Aoun, PA-C

  • Physician Assistant
  • Las Vegas, NV
  • NPI 1437408416
  NPD (past)

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1184993586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 POMERELLE AVE STE A2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182013",
            "telephone_number": "208-878-8817",
            "fax_number": "208-878-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 POMERELLE AVE.",
            "address_2": "SUITE A2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833181564",
            "telephone_number": "208-878-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN S. NELSON D.O. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "208-878-8817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804255700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alan S. Nelson D.O. PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Burley, ID
• Providers in Burley, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.