Individual provider Active NPI

Daniel R Nelson, M.D.

  • Obstetrics & Gynecology Physician
  • Carrollton, GA
National Provider Identifier
1235299819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
032005 Issued in GA
Practice address
156 Clinic Ave
Carrollton, GA 30117-4414
Phone
(770) 214-2229
Fax
(770) 214-9691
NPI assigned
Dec 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Obstetrics & Gynecology Physician 207V00000X 032005 GA Primary

Addresses

Primary practice location

156 Clinic Ave
Carrollton, GA 30117-4414

Mailing address

156 Clinic Ave
Carrollton, GA 30117-4414
Phone (770) 214-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20111108000438 GA Practitioner - Obstetrics/Gynecology 3072681667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Colorado School of Medicine, Denver, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

706 Dixie St
Suite 200
Carrollton, GA 30117-3889
Phone (770) 214-2229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032005GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joe E Parrish MD & James R Rash III Obstetrics & Gynecology CurrentSince Jul 1, 1966 Accepting new patients
Tanner Medical Group Inc Obstetrics & Gynecology CurrentSince May 30, 2022 Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients

Locations

156 Clinic Ave
Carrollton, GA 30117
Phone (770) 214-2229

706 Dixie St
Ste 200
Carrollton, GA 30117
Phone (770) 214-2121

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

690 Dallas Hwy
Ste 301
Villa Rica, GA 30180
Phone (770) 456-3850

Organizations & group practices 3

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 1

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235299819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174414",
            "telephone_number": "770-214-2229",
            "fax_number": "770-214-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174414",
            "telephone_number": "770-214-2229",
            "fax_number": "770-214-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "032005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.