Dean Allan Nelson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00352 Issued in ID

Practice address

267 N Canyon Dr
Gooding, ID 83330-5500

Phone

(208) 934-4446

Fax

(208) 934-4442

NPI assigned

Aug 20, 2006

Last updated

Mar 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID, TX2 enrollments

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 2

Specialty

Family Practice

Education

Ohio University, College of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metlakatla Indian CommunityGroup PAC ID 5890691315, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metlakatla Indian Community

  dba Annette Islands Service Unit

  • Health Service Clinic/Center
  • Metlakatla, AK
  • NPI 1740294081

  TX

  Medicare reassignment Care Compare group NPD
• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment NPD
• Steele Memorial Medical Center

  • Critical Access Hospital
  • Salmon, ID
  • NPI 1851403265
  Medicare reassignment NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Gooding, ID
  • NPI 1275703241
  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Imaging Center Twin Falls

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• St Luke's Clinic LLC

  dba St Lukes Clinic - Magic Valley/Jerome

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  NPD
• Steele Memorial Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Salmon, ID
  • NPI 1992913479
  NPD
• Horizon Emergency Physicians, P. C.

  • Emergency Medicine Physician
  • Hillsdale, MI
  • NPI 1952473688
  NPD (past)
• St. John's Lutheran Hospital, Inc.

  dba Cabinet Peaks Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Libby, MT
  • NPI 1588720882
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1285749101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 N CANYON DR",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833305500",
            "telephone_number": "208-934-4446",
            "fax_number": "208-934-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 N CANYON DR",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833305500",
            "telephone_number": "208-934-4446",
            "fax_number": "208-934-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DEAN",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "10491",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "00352",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "10491",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "00352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807560000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069207",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS",
            "identifier": "000096575",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francisca O Mendez
• Fred P Miller, FNP
• Marcy Lin Morrow, PAC
• Tyler Dawn Moulton, LCSW
• Aime Clarice Muntz, LMSW
• North Canyon Medical Center Inc. (North Canyon Medical Center)
• North Canyon Medical Center, Inc (North Canyon Medical Center)
• North Canyon Medical Center, Inc (North Canyon Medical Center)
• North Canyon Medical Center, Inc. (North Canyon Medical Center)
• North Canyon Medical Center, Inc. (North Canyon Family Medicine)

• Family Medicine Physician in Gooding, ID
• Providers in Gooding, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.