Individual provider Active NPI

Ross B Nelson III, MD

  • Pain Medicine (Anesthesiology) Physician
  • Shreveport, LA
National Provider Identifier
1275526592
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD.020504 Issued in LA
Practice address
1534 Elizabeth Ave Ste 201
Shreveport, LA 71101-4531
Phone
(318) 629-5505
Fax
(318) 629-5506
NPI assigned
Aug 23, 2005
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.020504 LA
Pain Medicine (Anesthesiology) Physician 207LP2900X MD.020504 LA Primary

Addresses

Primary practice location

1534 Elizabeth Ave Ste 201
Shreveport, LA 71101-4531

Mailing address

1534 Elizabeth Ave Ste 301
Shreveport, LA 71101-4531
Phone (318) 629-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000101 LA Practitioner - Anesthesiology 4183682719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in Shreveport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

1534 Elizabeth Ave
Suite 201
Shreveport, LA 71101-4531
Phone (318) 629-5451

8961 Youree Dr
Shreveport, LA 71115-3001
Phone (318) 671-8772

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.38 of 100Reported as group
Quality
87.5
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.020504LAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute of Louisiana, LLC Pain Medicine CurrentSince Sep 1, 2004 Accepting new patients
Musculoskeletal Institute of Louisiana, L.L.C. Anesthesiology CurrentSince Sep 1, 2004 Accepting new patients
Musculoskeletal Institute of Louisiana, LLC Pain Medicine PastSince Jan 1, 2004 Accepting new patients
Radiology Imaging Associates, LLP Past Accepting new patients
Surgical Specialty Center, LLC Past Accepting new patients

Locations

1500 Line Ave
Ste 100
Shreveport, LA 71101
Phone (318) 635-3052

1534 Elizabeth Ave
Ste 201
Shreveport, LA 71101
Phone (318) 629-5505

1534 Elizabeth Ave
Ste 301
Shreveport, LA 71101
Phone (318) 629-5002

2900 Hearne Ave
Shreveport, LA 71103
Phone (318) 635-3052

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ross.nelsonmd.p1@direct.msil.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1275526592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 ELIZABETH AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014531",
            "telephone_number": "318-629-5001",
            "fax_number": "318-629-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 ELIZABETH AVE STE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014531",
            "telephone_number": "318-629-5505",
            "fax_number": "318-629-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROSS",
        "middle_name": "B",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.020504",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "LA",
            "license": "MD.020504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.