NPIMap

Individual provider Active NPI

Bradley D Nelson, DPM

  • Podiatrist
  • Clinton, OK
National Provider Identifier
1285634469
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
230 Issued in OK
Practice address
207 S 30TH Street
Clinton, OK 73601
Phone
(580) 323-5800
Fax
(580) 323-5802
NPI assigned
Jul 28, 2005
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 230 OK Primary

Addresses

Primary practice location

207 S 30TH Street
Clinton, OK 73601

Mailing address

207 S 30TH Street
Clinton, OK 73601
Phone (580) 323-5800

Other identifiers 1

IdentifierTypeStateIssuer
200026910AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040702000245 OK Practitioner - Podiatry 4284611765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1925 W 3Rd St
Suite 3
Elk City, OK 73644-4303
Phone (580) 225-9955

207 S 30TH St
Clinton, OK 73601-3657
Phone (580) 323-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue478
Removal of skin lesions1-10
Removal of nail tissue1351
Removal or shaving of skin growth1105
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
230OKMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Clinic of Western Oklahoma PLLC Podiatrist CurrentSince Jul 1, 2004 Accepting new patients
Foot and Ankle Clinic of Western Oklahoma, PLLC Podiatrist CurrentSince Jul 1, 2004 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Farmers Union Hospital Association Past Accepting new patients
Foot and Ankle Clinic of Western Oklahoma Podiatrist Past Accepting new patients

Locations

207 S 30th St
Clinton, OK 73601
Phone (580) 323-5800

1925 W 3rd St
Ste 3
Elk City, OK 73644
Phone (580) 225-9955

900 N Main St
Elk City, OK 73644
Phone (580) 225-9955

Organizations & group practices 5

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 9

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1285634469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S 30TH STREET",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "73601",
            "telephone_number": "580-323-5800",
            "fax_number": "580-323-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S 30TH STREET",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "73601",
            "telephone_number": "580-323-5800",
            "fax_number": "580-323-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRADLEY",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200026910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.