Steven Charles Tackett-Nelson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD15455 Issued in OR

Practice address

821 Saginaw Street S
Salem, OR 97302

Phone

(503) 362-1999

Fax

(503) 362-9671

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

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.

• County of Polk

  • State or Local Public Health Clinic/Center
  • Dallas, OR
  • NPI 1710910781
  NPD (past)
• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD (past)
• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  NPD (past)
• Tillamook Family Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tillamook, OR
  • NPI 1063623478
  NPD (past)
• Tillamook Family Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tillamook, OR
  • NPI 1659380145
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245324797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SAGINAW STREET S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-362-1999",
            "fax_number": "503-362-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 SAGINAW STREET S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-362-1999",
            "fax_number": "503-362-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT-NELSON",
        "first_name": "STEVEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD15455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A006",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• T2 Imaging, Inc.
• Elizabeth Maree Tabor, PHARMD
• Tabula Rasa Wellness LLC
• Misty C. Tacker, BSN RN
• Regina Gaye Tackett-Nelson
• Vanessa Maria Tadeo
• Guinevere Noelle Tadina, RDH
• Daphne Tadlock, LPN
• Garth Ludwick Taft
• Jesanne Tageson-Ramirez, PA-C

• Psychiatry Physician in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.