Active NPI
Kristin Schad Nelson, DO
- Otolaryngology/Facial Plastic Surgery Physician
- Tempe, AZ
National Provider Identifier
1245441716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- License
- 4044
- Practice address
- 1492 S Mill Ave
Suite 301
Tempe, AZ 85281-5652 - Phone
- (480) 894-5550
- Fax
- (480) 894-9469
- NPI assigned
- May 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | 4044 | AZ | Primary |
Addresses
Primary practice location
1492 S Mill Ave
Suite 301
Tempe, AZ 85281-5652
Mailing address
1492 S Mill Ave
Suite 301
Tempe, AZ 85281-5652
Phone (480) 894-5550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227443 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4044 | AZ | MD | Otolaryngology/Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1245441716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1492 S MILL AVE",
"address_2": "SUITE 301",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852815652",
"telephone_number": "480-894-5550",
"fax_number": "480-894-9469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1492 S MILL AVE",
"address_2": "SUITE 301",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852815652",
"telephone_number": "480-894-5550",
"fax_number": "480-894-9469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KRISTIN",
"middle_name": "SCHAD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "AZ",
"license": "4044",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227443",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.