Individual provider Active NPI

Dorothy Karen Nelder, M.D.

  • Family Medicine Physician
  • Jesup, GA
National Provider Identifier
1285695338
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25530 Issued in AL
Practice address
930 S 1St St
Jesup, GA 31545
Phone
(912) 427-7790
Fax
(912) 427-7707
NPI assigned
Mar 29, 2006
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25530 AL Primary

Addresses

Primary practice location

930 S 1St St
Jesup, GA 31545

Mailing address

320 Peachtree St
Jesup, GA 31545-0244
Phone (912) 427-7790

Other identifiers 1

IdentifierTypeStateIssuer
051554297MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20241218001789 MI Practitioner - Family Practice 2860499829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4955 S M 88 Hwy
Bellaire, MI 49615-9082
Phone (231) 533-8649

601 Bridge St
East Jordan, MI 49727-9383

601 Bridge St
East Jordan, MI 49727-9421
Phone 2315362206168

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25530ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Jordan Family Health Center CurrentSince Nov 15, 2024 Accepting new patients
East Jordan Family Health Center CurrentSince Nov 15, 2024 Accepting new patients
Wayne SJC Medical Group, LLC Family Medicine CurrentSince Jul 9, 2018 Accepting new patients
Wayne SJC Medical Group, LLC CurrentSince Jul 9, 2018 Accepting new patients
Jordan Counseling PastSince Mar 7, 2021 Accepting new patients
Piedmont Emergency Rescue Past Accepting new patients
Jacksonville Internal Medicine Past Accepting new patients

Locations

125 Memorial Dr
Ste A
Jesup, GA 31545
Phone (912) 559-2337

320 Peachtree St
Jesup, GA 31545
Phone 8888180563300

930 S 1st St
Jesup, GA 31545
Phone (912) 385-2702

4955 S M 88 Hwy
Bellaire, MI 49615
Phone (231) 533-8649

601 Bridge St
East Jordan, MI 49727
Phone (231) 536-2206

Interoperability endpoints

  • Direct secure messaging: dorothy.nelder.p1@direct.ejfhc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA

Organizations & group practices 7

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1285695338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450244",
            "telephone_number": "912-427-7790",
            "fax_number": "912-427-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S 1ST ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "31545",
            "telephone_number": "912-427-7790",
            "fax_number": "912-427-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELDER",
        "first_name": "DOROTHY",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "25530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051554297",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

Verify at the official NPI Registry.