Individual provider Active NPI

Derek Nelson, PA MLS (ASCP)

  • Pathology Specialist/Technologist
  • Charleston, SC
National Provider Identifier
1275476699
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pathology Specialist/TechnologistTaxonomy code 246Q00000X
Practice address
171 Ashley Ave
Charleston, SC 29425-0100
Phone
(843) 405-2416
NPI assigned
Apr 10, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pathology Specialist/Technologist 246Q00000X SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0100

Mailing address

1324 Hamlin Park Cir
Mount Pleasant, SC 29466-7128
Phone (740) 408-4773

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1275476699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 HAMLIN PARK CIR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294667128",
            "telephone_number": "740-408-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "843-405-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DEREK",
        "name_prefix": "Prof.",
        "credential": "PA MLS (ASCP)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Q00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.