Individual provider Active NPI

Patrick S Nelson, PA-C

  • Physician Assistant
  • Dothan, AL
National Provider Identifier
1295067643
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA667 Issued in AL
Practice address
2431 W Main St
501
Dothan, AL 36301-1217
Phone
(334) 793-9222
Fax
(334) 671-0322
NPI assigned
Feb 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA667 AL Primary

Addresses

Primary practice location

2431 W Main St
501
Dothan, AL 36301-1217

Mailing address

2431 W Main St
501
Dothan, AL 36301-1217
Phone (334) 793-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101129000102 AL Practitioner - Physician Assistant 1759577083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Alabama PCGroup PAC ID 9436211463, 42 clinicians

Practice addresses (Care Compare)

1940 Stonegate Dr
Vestavia HLS, AL 35242-2541

2431 W Main St
Suite 501
Dothan, AL 36301-1274
Phone (205) 977-9876

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA667ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Dothan, LLC CurrentSince Sep 22, 2010 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Jere H. Weaver Past Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

2431 W Main St
Ste 501
Dothan, AL 36301
Phone (334) 793-9222

Interoperability endpoints

  • Direct secure messaging: pnelson@aldermatology.emadirect.md

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1295067643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "501",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-793-9222",
            "fax_number": "334-671-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "501",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-793-9222",
            "fax_number": "334-671-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PATRICK",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-10",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.