Individual provider Active NPI

James Leroy Nielsen, M.D.

  • Emergency Medicine Physician
  • Mitchell, SD
National Provider Identifier
1205806460
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2178 Issued in SD
Practice address
525 N Foster St
Mitchell, SD 57301-2966
Phone
(605) 995-2000
NPI assigned
Jan 23, 2006
Last updated
Sep 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2178 SD Primary
Emergency Medicine Physician 207P00000X 27171 IA

Addresses

Primary practice location

525 N Foster St
Mitchell, SD 57301-2966

Mailing address

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2000

Other identifiers 2

IdentifierTypeStateIssuer
1058677MedicaidIA
5605224MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000362 SD Practitioner - Emergency MedicinePractitioner - Family Practice 6305733510 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2178SDMDMental Health Counselor
27171IAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace Emergency Medicine CurrentSince Oct 1, 1999 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Oct 1, 1999 Accepting new patients
Avera Queen of Peace Current Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1205806460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N FOSTER ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012966",
            "telephone_number": "605-995-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N FOSTER ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012966",
            "telephone_number": "605-995-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "JAMES",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SD",
            "license": "2178",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "27171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1058677",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5605224",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.