Organization Active NPI

Byron Nelson PLLC

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1215646567
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BYRON NELSON PLLC
Practice address
1057 Highland Ave
Louisville, KY 40204-1960
Phone
(502) 994-0354
NPI assigned
Nov 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Mr. Christopher Byron Nelson, LCSWNPI 1508503731
Title
Owner
Phone
(502) 994-0354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1057 Highland Ave
Louisville, KY 40204-1960

Mailing address

1057 Highland Ave
Louisville, KY 40204-1960
Phone (502) 994-0354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240208004230 KY Part B Supplier - Clinic/Group Practice 1456794189 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

2210 Goldsmith Ln
Ste 201C
Louisville, KY 40218
Phone (502) 994-0354

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1215646567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 HIGHLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041960",
            "telephone_number": "502-994-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 HIGHLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041960",
            "telephone_number": "502-994-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRON NELSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BYRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-994-0354",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.