Individual provider Active NPI

Timothy S Nelson, M.D.

  • Emergency Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1205864675
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101242440 Issued in VA
Practice address
736 Battlefield Blvd N
Emergency Department
Chesapeake, VA 23320-4941
Phone
(757) 312-6200
Fax
(757) 312-6181
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 MD070350L PA
Emergency Medicine Physician 207P00000X 0101242440 VA Primary

Addresses

Primary practice location

736 Battlefield Blvd N
Emergency Department
Chesapeake, VA 23320-4941

Mailing address

109 G Gainsborough Square
Box 723
Chesapeake, VA 23320
Phone (757) 490-9388

Other identifiers 3

IdentifierTypeStateIssuer
P00470490OtherVARR MEDICARE
015337T83OtherVAMEDICARE
1205864675MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080104000475 VA Practitioner - Emergency Medicine 5799865622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Observation Medicine Specialists PCGroup PAC ID 3577045053, 19 clinicians
Tidewater Emergency Medical Care, LTD..Group PAC ID 4183538150, 18 clinicians

Practice addresses (Care Compare)

736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 490-9388

736 Battlefield N Blvd
Chesapeake, VA 23320-4941
Phone (757) 312-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as group
Quality
88.62
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD070350LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Emergency Medical Care, LTD. Emergency Medicine CurrentSince Nov 1, 2007 Accepting new patients
Chesapeake Observation Medicine Specialists, P.C. Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 Accepting new patients
Family Health Associates of Geisinger Lewistown Hospital Past Accepting new patients

Locations

109 Gainsborough Sq
Ste G
Chesapeake, VA 23320
Phone (757) 490-9388

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1205864675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 G GAINSBOROUGH SQUARE",
            "address_2": "BOX 723",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-490-9388",
            "fax_number": "757-490-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BATTLEFIELD BLVD N",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204941",
            "telephone_number": "757-312-6200",
            "fax_number": "757-312-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-07-26",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD070350L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101242440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00470490",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "015337T83",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205864675",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.