Individual provider Active NPI

Chris E Nelson, MD

  • Pediatrics Physician
  • Chehalis, WA
National Provider Identifier
1235224437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00019016 Issued in WA
Practice address
370 S Market Blvd
Chehalis Children'S Clinic PS
Chehalis, WA 98532
Phone
(360) 748-6693
Fax
(360) 748-3619
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00019016 WA Primary

Addresses

Primary practice location

370 S Market Blvd
Chehalis Children'S Clinic PS
Chehalis, WA 98532

Mailing address

370 S Market Blvd
Chehalis, WA 98532
Phone (360) 748-6693

Other identifiers 1

IdentifierTypeStateIssuer
1074418MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20101108000467 WA Practitioner - Pediatric Medicine 8628263407 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Sep 2, 2010 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 2, 2010 Accepting new patients
Chehalis Children'S Clinic PS Pediatrics CurrentSince Aug 22, 1996 Accepting new patients
Providence Health & Services Washington Current Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

370 S Market Blvd
Chehalis, WA 98532
Phone (360) 748-6693

Interoperability endpoints

  • Direct secure messaging: cnelson@nwpc.opdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235224437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-748-6693",
            "fax_number": "360-748-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 S MARKET BLVD",
            "address_2": "CHEHALIS CHILDREN'S CLINIC PS",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-748-6693",
            "fax_number": "360-748-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CHRIS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00019016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1074418",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.