Active NPI
Richard E Nelson, ATC
- Athletic Trainer
- Bellevue, NE
National Provider Identifier
1194837617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 138
- Practice address
- 1401 High School Dr
Bellevue, NE 68005-3275 - Phone
- (706) 331-5885
- Fax
- (402) 293-4259
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 14, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 138 | NE | Primary |
Addresses
Primary practice location
1401 High School Dr
Bellevue, NE 68005-3275
Mailing address
1401 High School Dr
Bellevue, NE 68005-3275
Phone (706) 331-5885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138 | NE | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1194837617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 HIGH SCHOOL DR",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "680053275",
"telephone_number": "706-331-5885",
"fax_number": "402-293-4259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 HIGH SCHOOL DR",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "680053275",
"telephone_number": "706-331-5885",
"fax_number": "402-293-4259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "RICHARD",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.