Theodora J Nelson, MD

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

G75021 Issued in CA

Practice address

7910 Frost St Ste 230
San Diego, CA 92123-2776

Phone

(858) 246-0053

Fax

(619) 496-9257

NPI assigned

Sep 28, 2006

Last updated

Apr 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Childrens Healthcare Medical Associates

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1881701332
  NPD (past)
• Pediatric Primary Care Associated Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1356631972
  NPD (past)
• Dowd Medical Associates

  • Specialist
  • Reading, MA
  • NPI 1043420714
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1326130584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 FROST ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232776",
            "telephone_number": "858-246-0053",
            "fax_number": "858-496-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232776",
            "telephone_number": "858-246-0053",
            "fax_number": "619-496-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "THEODORA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G75021",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "G75021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler Nelson
• Stephen Nelson, PT, DPT
• Stephen Alexander Nelson
• Sumiko Nelson, MA, CCC
• Terra Renee Nelson, MPT
• Tracy Beth Nelson, NP
• Trevin Nelson, BCBA
• Yuliana Noniyeva Nelson, PHD
• Zoe Nelson
• Diana Nelte

• Developmental - Behavioral Pediatrics Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Developmental - Behavioral Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.