Jeffrey Thomas Nelson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11411 Issued in FL

Practice address

960 Back Stage LN
Lake Buena Vista, FL 32830-8472

Phone

(407) 934-4100

Fax

(407) 934-4101

NPI assigned

Nov 16, 2010

Last updated

Mar 17, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• West Orange Family Medical Care,PA

  • Family Medicine Physician
  • Winter Garden, FL
  • NPI 1184710295
  Medicare reassignment NPD
• Sigma Medical Group, LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1831627579
  NPD (past)

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295036697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-4100",
            "fax_number": "407-934-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-4100",
            "fax_number": "407-934-4101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2106 N Orange Ave # 100",
            "address_2": "Orange Ave Consulting",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328045535",
            "country_code": "US",
            "telephone_number": "407-459-1181",
            "fax_number": "321-732-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynnette Hall, M.D.
• Michael Wayne Hankins, M.D.
• Sharon Rae Krumins, M.D.
• Lisa Clayville Martin, PHARMD
• Joseph Carney Metz III, MS, ATC, CSCS
• Melvin Nguyen, PHARMD
• Boris Fabricio Onate, M.D
• Phuong K Ong, PHARM D
• Premise Health of Florida Medical PA (Center for Living Well)
• Nicholas Randall Reis

• Family Medicine Physician in Lake Buena Vista, FL
• Providers in Lake Buena Vista, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.