Kim Leslie Nelson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15939 Issued in TX

Practice address

6751 Rufe Snow Dr
Suite 850
Fort Worth, TX 76148-2319

Phone

(817) 656-8777

Fax

(817) 581-2073

NPI assigned

Apr 26, 2007

Last updated

Jul 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1326268160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 RUFE SNOW DR",
            "address_2": "SUITE 850",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761482319",
            "telephone_number": "817-656-8777",
            "fax_number": "817-581-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 RUFE SNOW DR",
            "address_2": "SUITE 850",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761482319",
            "telephone_number": "817-656-8777",
            "fax_number": "817-581-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KIM",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "15939",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Nelson, M.S. CF-SLP
• Dehija Nelson
• Derek Dee Nelson, D.C.
• Edward Reese Nelson Jr., M.D.
• Hattie Hoskins Nelson, NP
• Marian K Nelson, CRNA
• Mark J Nelson, M.D.
• Michael Adam Nelson, EMTP
• Monica J Nelson, PMHNP
• Rochelle Ann Nelson, MA, BCBA

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.