Nelson Nelson Nelson OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1011 Issued in OK

Legal business name

NELSON NELSON NELSON OD INC

Practice address

203 N Noble Ave
Watonga, OK 73772-0590

Phone

(580) 623-5073

Fax

(580) 623-5020

NPI assigned

Sep 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Layne Nelson, OD

Title

Owner

Phone

(580) 623-5073

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1285736355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N NOBLE AVE",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737720590",
            "telephone_number": "580-623-5073",
            "fax_number": "580-623-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N NOBLE AVE",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737720590",
            "telephone_number": "580-623-5073",
            "fax_number": "580-623-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON NELSON NELSON OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-623-5073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1011",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "1011",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100768490B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mercy Hospital Watonga, Inc.
• Sabrina Miller
• Steven Brock Miller, D.D.S.
• Federico Mosqueda, BS
• Jennifer Mozingo
• Timothy L Nelson, OD
• Krysta Nowlin
• Oklahoma Mental Health Council
• Oklahoma Mental Health Council
• Opportunities, Inc. BCS

• Optometrist in Watonga, OK
• Providers in Watonga, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.