Individual provider Active NPI

David Wesley Nelson, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1235618497
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01074 Issued in RI
Practice address
345 Blackstone Blvd
Providence, RI 02906-4829
Phone
(401) 455-6200
Fax
(401) 455-6689
NPI assigned
Aug 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01074 RI
Physician Assistant 363A00000X PA01074 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd
Providence, RI 02906-4829

Mailing address

455 Toll Gate Rd
PRC and Credentialing
Warwick, RI 02886-2759
Phone (401) 273-0641

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address dwnelson@direct.carene.org Health Information Exchange (HIE)
Direct Messaging Address dwnelson@direct.carene.org Health Information Exchange (HIE)
Direct Messaging Address dwnelson@direct.carene.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926003189 RI Practitioner - Physician Assistant 4981955127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

455 Tollgate Rd
Warwick, RI 02886-2759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: dwnelson@direct.carene.org

Organizations & group practices 2

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1235618497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064829",
            "telephone_number": "401-455-6200",
            "fax_number": "401-455-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DAVID",
        "middle_name": "WESLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA01074",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwnelson@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blvd",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029064829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwnelson@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blvd",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029064829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwnelson@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blvd",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029064829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.