Craig Lee Nelson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12006413A Issued in IN

Practice address

405 Union St
Lagrange, IN 46761-2234

Phone

(260) 463-3123

NPI assigned

May 14, 2007

Last updated

Mar 14, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Craig L Nelson DDS Inc

  • General Practice Dentistry
  • Lagrange, IN
  • NPI 1558305326
  NPD (past) Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1396950176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 UNION ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612234",
            "telephone_number": "260-463-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 UNION ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612234",
            "telephone_number": "260-463-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CRAIG",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12006413A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100159780A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robinn G Mitchell, MSW
• Julie Moore, MSW
• Michele A Moore, N.P.
• Kamran Mushtaq, MD
• Sumant Nanduri, MBBS, MD
• Lilee Nguyen, PA-C
• Kerri Lauren Nickles, ED.S.
• Northeast Indiana Urology PC
• Northeast Internal Medicine Associates, PC
• Northeast Internal Medicine Associates, PC

• General Practice Dentistry in Lagrange, IN
• Providers in Lagrange, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.