Active NPI
Mary Baron Nelson, RN CPNP
- Pediatric Registered Nurse
- Los Angeles, CA
National Provider Identifier
1407178775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Registered Nurse
- License
- 363LP0200X
- Practice address
- 4650 W Sunset Blvd
Ms #81
Los Angeles, CA 90027-6062 - Phone
- (323) 361-3033
- NPI assigned
- Feb 26, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 363LP0200X | CA | Primary |
Addresses
Primary practice location
4650 W Sunset Blvd
Ms #81
Los Angeles, CA 90027-6062
Mailing address
5272 La Canada Blvd
La Canada, CA 91011-1722
Phone (818) 952-0416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 363LP0200X | CA | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397088000000",
"number": "1407178775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5272 LA CANADA BLVD",
"city": "LA CANADA",
"state": "CA",
"postal_code": "910111722",
"telephone_number": "818-952-0416",
"fax_number": "323-361-8191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD",
"address_2": "MS #81",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062",
"telephone_number": "323-361-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARON NELSON",
"first_name": "MARY",
"credential": "RN CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-26",
"last_updated": "2014-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "CA",
"license": "363LP0200X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.