Individual provider Active NPI

Jennifer Nelson, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1326428798
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S9945 Issued in TX
Practice address
10407 State Highway 151
San Antonio, TX 78251-4551
Phone
(210) 877-5600
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S9945 TX Primary

Addresses

Primary practice location

10407 State Highway 151
San Antonio, TX 78251-4551

Mailing address

9035 Wellesley Manor Dr
San Antonio, TX 78240-2165
Phone (701) 720-2718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180823002846 OK Practitioner - Pediatric Medicine 0446509491 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S9945TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 16, 2018 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 16, 2018 Accepting new patients
Caring for Kids Pediatrics, PA Pediatrics PastSince Jan 2, 2022 Accepting new patients

Locations

1200 Childrens Ave
Oklahoma City, OK 73104
Phone (405) 271-2429

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

1200 Childrens Ave
#14000
Oklahoma City, OK 73104
Phone (405) 271-4417

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1326428798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 WELLESLEY MANOR DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402165",
            "telephone_number": "701-720-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10407 STATE HIGHWAY 151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514551",
            "telephone_number": "210-877-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S9945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.