Individual provider Active NPI

David Taylor Nellis, MSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1255716395
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008082A Issued in IN
Practice address
5200 Washington Ave
Ste D
Evansville, IN 47715-4863
Phone
(812) 437-1700
Fax
(812) 437-1702
NPI assigned
Jul 29, 2015
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008082A IN Primary

Addresses

Primary practice location

5200 Washington Ave
Ste D
Evansville, IN 47715-4863

Mailing address

5200 Washington Ave
Ste D
Evansville, IN 47715-4863
Phone (812) 437-1700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180416000002 IN Practitioner - Clinical Social Worker 5597028050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Behavioral Health LLCGroup PAC ID 4587834874, 132 clinicians

Practice addresses (Care Compare)

7300 E Indiana St
Suite 103
Evansville, IN 47715-7448
Phone (812) 401-8008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Behavioral Health LLC Social Worker CurrentSince Dec 20, 2024 Accepting new patients

Locations

7300 E Indiana St
Ste 103
Evansville, IN 47715
Phone (812) 401-8008

Organizations & group practices 1

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1255716395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WASHINGTON AVE",
            "address_2": "STE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154863",
            "telephone_number": "812-437-1700",
            "fax_number": "812-437-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WASHINGTON AVE",
            "address_2": "STE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154863",
            "telephone_number": "812-437-1700",
            "fax_number": "812-437-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIS",
        "first_name": "DAVID",
        "middle_name": "TAYLOR",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008082A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.