Individual provider Active NPI

Dennis Pernell Nelson

  • Non-emergency Medical Transport (VAN)
  • Gloucester, VA
National Provider Identifier
1215532932
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
T67-58-30-0166 Issued in VA
Practice address
9448 Marlfield Rd
Gloucester, VA 23061-3322
Phone
(804) 815-9277
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X T67-58-30-0166 VA Primary

Addresses

Primary practice location

9448 Marlfield Rd
Gloucester, VA 23061-3322

Mailing address

9448 Marlfield Rd
Gloucester, VA 23061-3322
Phone (804) 815-9277

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

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1215532932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9448 MARLFIELD RD",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613322",
            "telephone_number": "804-815-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9448 MARLFIELD RD",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613322",
            "telephone_number": "804-815-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DENNIS",
        "middle_name": "PERNELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "VA",
            "license": "T67-58-30-0166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.