Individual provider Active NPI

Craig Livezey Nelson, DMD

  • Prosthodontics
  • Saint Petersburg, FL
National Provider Identifier
1306861653
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
475 Issued in SC
Practice address
VA Health Care System
10,000 Bay Pines Boulvard
Saint Petersburg, FL 33708
Phone
(727) 398-9396
Fax
(727) 319-1146
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 3340 SC
Prosthodontics 1223P0700X 475 SC Primary

Addresses

Primary practice location

VA Health Care System
10,000 Bay Pines Boulvard
Saint Petersburg, FL 33708

Mailing address

1257 Waterfront Drive
Mount Pleasant, SC 29464-9494
Phone (843) 849-7046

Other identifiers 1

IdentifierTypeStateIssuer
3340OtherSCDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3340SCMDProsthodontist
475SCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1306861653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 WATERFRONT DRIVE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649494",
            "telephone_number": "843-849-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA HEALTH CARE SYSTEM",
            "address_2": "10,000 BAY PINES BOULVARD",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "33708",
            "telephone_number": "727-398-9396",
            "fax_number": "727-319-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CRAIG",
        "middle_name": "LIVEZEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "SC",
            "license": "3340",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "SC",
            "license": "475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "3340",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.