Individual provider Active NPI

Jean Audrey Nelson, FNP-C

  • Allergy & Immunology Physician
  • Scottsdale, AZ
National Provider Identifier
1205835337
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
AP 1768 Issued in AZ
Practice address
7514 E Monterey Way
Suite 1
Scottsdale, AZ 85251-6900
Phone
(480) 949-7377
Fax
(480) 949-8339
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X AP 1768 AZ Primary

Addresses

Primary practice location

7514 E Monterey Way
Suite 1
Scottsdale, AZ 85251-6900

Mailing address

7514 E Monterey Way
Suite 1
Scottsdale, AZ 85251-6900
Phone (480) 949-7377

Other identifiers 1

IdentifierTypeStateIssuer
873415MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20040628000255 AZ Practitioner - Nurse Practitioner 6709862071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy, Asthma and Immunology Associates LTDGroup PAC ID 8123003829, 7 clinicians

Practice addresses (Care Compare)

7514 E Monterey Way
Suite 1
Scottsdale, AZ 85251-6900
Phone (480) 949-7377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP 1768AZMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy, Asthma & Immunology Associates LTD CurrentSince May 1, 2004 Accepting new patients

Locations

3370 S Mercy Rd
Ste 301
Gilbert, AZ 85297
Phone (480) 637-0687

7514 E Monterey Way
Ste 1
Scottsdale, AZ 85251
Phone (480) 889-6328

10200 N 92nd St
Ste 130
Scottsdale, AZ 85258
Phone (480) 614-8011

Organizations & group practices 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1205835337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 E MONTEREY WAY",
            "address_2": "SUITE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516900",
            "telephone_number": "480-949-7377",
            "fax_number": "480-949-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 E MONTEREY WAY",
            "address_2": "SUITE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516900",
            "telephone_number": "480-949-7377",
            "fax_number": "480-949-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JEAN",
        "middle_name": "AUDREY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "AP 1768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "873415",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.