Gregory Clifford Nelson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1121110 Issued in CA

Practice address

101 Bodin Cir
Travis AFB, CA 94535-1809

Phone

(707) 423-7611

NPI assigned

Nov 20, 2014

Last updated

Nov 20, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Kenneth P Martinez MD a Medical Corp

  dba Neurology & Pain Specialty Center

  • Neurology Physician
  • Aliso Viejo, CA
  • NPI 1255537957
  Medicare reassignment

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1396142311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 MANZANO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-412-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GREGORY",
        "middle_name": "CLIFFORD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1121110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Dee Myers, DDS
• David Jonathan Myers, M.D.
• National Vision, Inc.
• Michael Gene Neilson, DMD
• Gregg Bradley Nelson
• Jens Dean Nelson, D.M.D
• Vasyl Nesteryuk, DO
• Bridget Shannon Nestor-Arjun
• Jessica Newcomb, DNP-CRNA
• Sieu Ngo, O.D.

• Physician Assistant in Travis AFB, CA
• Providers in Travis AFB, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.