Individual provider Active NPI

Douglas R Nelson, MD

  • Allergy & Immunology Physician
  • La Crosse, WI
National Provider Identifier
1356331862
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
30242 Issued in WI
Practice address
800 West Ave S
La Crosse, WI 54601-8806
Phone
(608) 392-9881
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30242 WI
Allergy & Immunology Physician 207K00000X 30242 WI Primary

Addresses

Primary practice location

800 West Ave S
La Crosse, WI 54601-8806

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dnelson26864@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100618000144 WI Practitioner - Pediatric MedicinePractitioner - Allergy/Immunology 7214067206 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Mar 20, 2020 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Interoperability endpoints

  • Direct secure messaging: dnelson26864@ehrdirect.mayoclinicmsg.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1356331862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018806",
            "telephone_number": "608-392-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "30242",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WI",
            "license": "30242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnelson26864@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 West Ave S",
            "city": "La Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546018806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.