Brent Gregory Nelson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

58137 Issued in MN

Practice address

6363 France Ave S Ste 200
Edina, MN 55435-2140

Phone

(952) 230-9100

Fax

(952) 922-2525

NPI assigned

May 12, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Psychiatry

Education

University of Minnesota Medical School, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Croix Psychiatric, LLC

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1275825945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352140",
            "telephone_number": "952-230-9100",
            "fax_number": "952-922-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRENT",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "58137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jai Negri, MSW LGSW
• Timothy James Neher, MD
• Neil C Bonstrom DDS PA
• Jille Neiman, LPCC
• Jessica Robin Nelson-Mitchell, LAMFT, LADC
• Brian Deane Nelson, MD
• Casey Lee Nelson, DDS
• David Matthew Nelson, MD
• Debra A Nelson, CRNA
• Eric Richard Nelson, M.D.

• Psychiatry Physician in Edina, MN
• Providers in Edina, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.