NPIMap

Individual provider Active NPI

Keith J Nelson, M.D.

  • Orthopaedic Surgery Physician
  • Logan, UT
National Provider Identifier
1245229954
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5924248-1205 Issued in UT
Practice address
2310 N 400 E
Ste a
Logan, UT 84341-1788
Phone
(435) 787-2000
Fax
(435) 787-1913
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5924248-1205 UT Primary

Addresses

Primary practice location

2310 N 400 E
Ste a
Logan, UT 84341-1788

Mailing address

2310 N 400 E
Ste a
Logan, UT 84341-1788
Phone (435) 787-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050330000854 UT Practitioner - Orthopedic Surgery 4587614110 Reassigns benefits to 1 organization
I20080222000372 ID Practitioner - Orthopedic Surgery 4587614110 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Utah School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Management and ConsultingGroup PAC ID 5496659245, 21 clinicians
Caribou Medical Center, IncGroup PAC ID 7618365701, 35 clinicians

Practice addresses (Care Compare)

164 S 5TH St
Montpelier, ID 83254-1557
Phone (435) 787-2000

2310 N 400
Suite a
North Logan, UT 84341-1796
Phone (435) 787-2000

300 S 3Rd
Soda Springs, ID 83276-1559
Phone 20854733417503

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement18
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5924248-1205UTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Management and Consulting Orthopaedic Surgery CurrentSince Oct 1, 1999 Accepting new patients
Caribou Medical Center, Inc Clinic/Center CurrentSince May 1, 2025 Accepting new patients
Caribou Medical Center, Inc CurrentSince May 1, 2025 Accepting new patients
RMC Management, LLC Clinic/Center Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Clinic/Center Past Accepting new patients

Locations

164 S 5th St
Montpelier, ID 83254
Phone (208) 847-1630

44 N 1st E
Preston, ID 83263
Phone (208) 852-0137

64 N 1st E
Preston, ID 83263
Phone (208) 852-3662

300 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-0700

1030 S Medical Dr
Ste A
Brigham City, UT 84302
Phone (435) 723-4500

55 E Golf Course Rd
Unit B
Logan, UT 84321

55 E Golf Course Rd
Logan, UT 84321
Phone (435) 760-3734

2310 N 400 E
Ste A
North Logan, UT 84341
Phone (435) 774-8547

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: knelson@alpineortho.emadirect.md

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1245229954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N 400 E",
            "address_2": "STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411788",
            "telephone_number": "435-787-2000",
            "fax_number": "435-787-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N 400 E",
            "address_2": "STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411788",
            "telephone_number": "435-787-2000",
            "fax_number": "435-787-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KEITH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "5924248-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.