NPIMap

Individual provider Active NPI

Tyler J Nelson, M.D.

  • Internal Medicine Physician
  • Bryant, AR
National Provider Identifier
1306814546
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E4284 Issued in AR
Practice address
319 Bryant Ave
Suite 1
Bryant, AR 72022-3815
Phone
(501) 653-0353
Fax
(501) 653-0347
NPI assigned
Mar 14, 2006
Last updated
Jun 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E4284 AR Primary

Addresses

Primary practice location

319 Bryant Ave
Suite 1
Bryant, AR 72022-3815

Mailing address

PO Box 1615
Searcy, AR 72145-1615
Phone (501) 776-6093

Other identifiers 1

IdentifierTypeStateIssuer
157559001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000968 AR Practitioner - Internal Medicine 5092745521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saline Clinics LLCGroup PAC ID 0547553836, 26 clinicians

Practice addresses (Care Compare)

3412 Market Place Ave
B Bryant Medical Clinic
Bryant, AR 72022-8054
Phone (501) 653-0353

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4284ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saline Clinics LLC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Bryant Medical Clinic Internal Medicine Current Accepting new patients
Central Arkansas Spine Specialist Past Accepting new patients

Locations

5 Medical Park Dr
Ste 305
Benton, AR 72015
Phone (501) 574-7400

910 N East St
Benton, AR 72015
Phone (501) 381-2001

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

319 Bryant Ave
Ste 1
Bryant, AR 72022
Phone (501) 653-0353

3412 Market Place Ave
#B
Bryant, AR 72022
Phone (501) 653-0353

904 Autumn Rd
Ste 500
Little Rock, AR 72211
Phone (501) 202-4088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16686/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tyler.nelson.1@16686.direct.athenahealth.com
  • Direct secure messaging: tylernelson-mmbmc@direct.medalliesmail.com

Organizations & group practices 3

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 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1306814546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1615",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721451615",
            "telephone_number": "501-776-6093",
            "fax_number": "501-776-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 BRYANT AVE",
            "address_2": "SUITE 1",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720223815",
            "telephone_number": "501-653-0353",
            "fax_number": "501-653-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TYLER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E4284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157559001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryant, AR

Sources for this page

Verify at the official NPI Registry.