Eric R Nelson MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ERIC R NELSON MD PC

Practice address

3101 Clearwater Dr
Suite a
Prescott, AZ 86305-7180

Phone

(480) 985-1093

NPI assigned

Nov 8, 2007

Organization subpart

No

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

Authorized official

Name

Eric R Nelson, MDNPI 1376541805

Title

President

Phone

(480) 985-1093

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Reynold Nelson, M.D.

  • Surgery Physician
  • Prescott, AZ
  • NPI 1376541805
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1376723189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 CLEARWATER DR",
            "address_2": "SUITE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057180",
            "telephone_number": "480-985-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 CLEARWATER DR",
            "address_2": "SUITE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057180",
            "telephone_number": "480-985-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC R NELSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-985-1093",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.