Gunnar Nelson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS13835 Issued in FL

Practice address

325 MDG
325 MDG, 340 Magnolia Circle
Tyndall Afb, FL 32403

Phone

(850) 283-7700

NPI assigned

Jul 17, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 Practice

Education

Lincoln Memorial University Medical Department, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apc, IncGroup PAC ID 2961540521, 4 clinicians

South Tampa After Hours Clinic, LLCGroup PAC ID 9436299138, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• South Tampa After Hours Clinic, LLC

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1063694735
  Medicare reassignment Care Compare group NPD
• Apc, Inc.

  • Interventional Pain Medicine Physician
  • Tampa, FL
  • NPI 1871791368
  Medicare reassignment Care Compare group
• Largo Physician Group, LLC

  • Pediatrics Physician
  • Brooksville, FL
  • NPI 1578732889
  Medicare reassignment NPD

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1386051761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324035604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MDG",
            "address_2": "325 MDG, 340 MAGNOLIA CIRCLE",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32403",
            "telephone_number": "850-283-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GUNNAR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING LICENSE NUMBER",
            "identifier": "UO4239",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dijanae Moody
• David Morse, PHARMD
• Megan Sue Mould, LCSW
• Lillybeth Muniz Lugo
• Jose Victor Nazario, IDMT
• Drew Robert Oen, PT, DPT
• Joshua Parker, IDMT
• Jae J. Pate, LCSW
• Chasity Lynn Pierce
• Jennifer Lynn Pippin, M.D.

• Family Medicine Physician in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.