Individual provider Active NPI

Maureen Rebecca Nelson, O.D.

  • Optometrist
  • Sioux City, IA
National Provider Identifier
1245480540
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002437 Issued in IA
Practice address
2513 Hamilton Blvd
Sioux City, IA 51104-4045
Phone
(712) 252-0933
Fax
(712) 252-0913
NPI assigned
Sep 23, 2008
Last updated
Feb 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002437 IA Primary

Addresses

Primary practice location

2513 Hamilton Blvd
Sioux City, IA 51104-4045

Mailing address

2513 Hamilton Blvd
Sioux City, IA 51104-4045
Phone (712) 252-0933

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000573 IA Practitioner - Optometry 1052479912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hawkeye Exact, LLC Optometrist PastSince Nov 24, 2019 Accepting new patients
Osceola Vision Center P.C. Optometrist PastSince Jun 27, 1997 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1245480540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 HAMILTON BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511044045",
            "telephone_number": "712-252-0933",
            "fax_number": "712-252-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 HAMILTON BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511044045",
            "telephone_number": "712-252-0933",
            "fax_number": "712-252-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MAUREEN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.