NPIMap

Individual provider Active NPI

Stephen Lanier Nelson, MD

  • Family Medicine Physician
  • Medford, OR
National Provider Identifier
1356362008
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD18996 Issued in OR
Practice address
749 Golf View Dr Unit a
Medford, OR 97504-9654
Phone
(541) 282-6580
Fax
(541) 326-0361
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD18996 OR Primary

Addresses

Primary practice location

749 Golf View Dr Unit a
Medford, OR 97504-9654

Mailing address

749 Golf View Dr Unit a
Medford, OR 97504-9654
Phone (541) 282-6580

Other identifiers 1

IdentifierTypeStateIssuer
066043MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000041 OR Practitioner - Family Practice 5698778009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

749 Golf View Dr
Unit a
Medford, OR 97504-9654
Phone (541) 282-6580

Hospital & facility affiliations

  • Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
  • Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
  • Riverside Home Health Care Home health agency, Grants Pass, OR, CCN 387143
  • Asante Hospice Hospice, Talent, OR, CCN 381527
  • Bristol Hospice- Rogue Valley, LLC Hospice, Grants Pass, OR, CCN 381572
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Avamere at Three Fountains Nursing home, Medford, OR, CCN 385126

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Retina Specialists, LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

2859 State St
Ste 103
Medford, OR 97504
Phone (541) 282-6580

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356362008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 GOLF VIEW DR UNIT A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049654",
            "telephone_number": "541-282-6580",
            "fax_number": "541-326-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 GOLF VIEW DR UNIT A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049654",
            "telephone_number": "541-282-6580",
            "fax_number": "541-326-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "STEPHEN",
        "middle_name": "LANIER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD18996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066043",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.