John Clayton Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

08024 Issued in MS

Practice address

1146 Evelyn Gandy Pkwy
Petal, MS 39465-3947

Phone

(601) 584-4309

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Mississippi School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Magee General Hospital Hospital, Magee, MS, CCN 250124
• Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  MS

  Medicare reassignment Care Compare group NPD
• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment NPD
• Hancock Emergency Group LLC

  • Emergency Medicine Physician
  • Bay St Louis, MS
  • NPI 1295142396
  Medicare reassignment NPD
• Magee Benevolent Association

  • Family Nurse Practitioner
  • Raleigh, MS
  • NPI 1225157258
  Medicare reassignment NPD
• South Mississippi Emergency Physicians,PA

  • Family Medicine Physician
  • Sumrall, MS
  • NPI 1356531594
  NPD Authorized official
• Magee Benevolent Association

  • General Acute Care Hospital
  • Magee, MS
  • NPI 1396865754
  NPD
• Magee Benevolent Association

  • General Acute Care Hospital
  • Magee, MS
  • NPI 1679553994
  NPD
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  NPD (past)

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

• Baptist Memorial Hospital Union County, Inc.

  • General Acute Care Hospital
  • New Albany, MS
  • NPI 1780648352
  Care Compare affiliation
• Magee Benevolent Association

  • General Acute Care Hospital
  • Magee, MS
  • NPI 1679553994
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1366470056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 EVELYN GANDY PKWY",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394653947",
            "telephone_number": "601-584-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 EVELYN GANDY PKWY",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394653947",
            "telephone_number": "601-584-4309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6051 Highway 49",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017200",
            "country_code": "US",
            "telephone_number": "601-288-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHN",
        "middle_name": "CLAYTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "08024",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "08024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019517",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geralynn G. Morrison, M.D.
• Sherry Lazenby Mulling, M.S., CCC-SLP
• James Thomas Murray Jr.
• Stephanie Murray, CMHT
• Ramon Monroe Napier, D.M.D.
• Hang My-Thi Nguyen, FNP
• Julie Pace, RD
• Pacific Physician Services LLC
• Paki Inc
• Kimberly Nicole Patrick

• Family Medicine Physician in Petal, MS
• Providers in Petal, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.