Active NPI
Evan C. Nelson, PA
- Physician Assistant
- Muscatine, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002293
- Practice address
- 1518 Mulberry Ave
Muscatine, IA 52761-3433 - Phone
- (563) 262-4110
- Fax
- (563) 264-0166
- NPI assigned
- Aug 9, 2012
- Last updated
- Apr 23, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002293 | IA | Primary |
Addresses
Primary practice location
1518 Mulberry Ave
Muscatine, IA 52761-3433
Mailing address
1518 Mulberry Ave
Muscatine, IA 52761-3433
Phone (563) 264-9508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
106 19TH Ave
Suite 103
Moline, IL 61265-3700
Phone (309) 779-7050
3904 16TH St
Moline, IL 61265-1275
3912 16TH St
Moline, IL 61265-1275
Phone (309) 581-7600
3924 16TH St
Moline, IL 61265-1275
Phone (309) 779-5260
600 N College Ave
Suite 120
Geneseo, IL 61254-1095
Phone (309) 944-5342
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002293 | IA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Physician Assistant | Current | Accepting new patients |
| St Luke's Methodist Hospital | Current | Accepting new patients | |
| Iowa Physicians Clinic Medical Foundation | Current | Accepting new patients | |
| Trinity Medical Center | Physician Assistant | Past | Accepting new patients |
Locations
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110
600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342
3904 16th St
Ste C
Moline, IL 61265
Phone (309) 581-7610
Interoperability endpoints
- enelson162139@direct.unitypoint.org
Organizations & group practices 4
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.
-
dba UnityPoint Clinic
- General Practice Physician
- West Des Moines, IA
- NPI 1366425274
IL
-
dba Unitypoint Clinic Family Medicine - Anthon
- Rural Health Clinic/Center
- Anthon, IA
- NPI 1053203927
Physician Assistant
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Emergency Medicine Physician
- Rock Island, IL
- NPI 1568414134
Physician Assistant
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Trinity Rock Island
- General Acute Care Hospital
- Rock Island, IL
- NPI 1316047632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1396092359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 MULBERRY AVE",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613433",
"telephone_number": "563-264-9508",
"fax_number": "563-264-0166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 MULBERRY AVE",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527613433",
"telephone_number": "563-262-4110",
"fax_number": "563-264-0166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "EVAN",
"middle_name": "C.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-09",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "002293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muscatine, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.