NPIMap

Individual provider Active NPI

Brett Aric Nelson, M.D.

  • Internal Medicine Physician
  • Pulaski, TN
National Provider Identifier
1417076290
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
061500 Issued in GA
Practice address
1255 E College St
Suite 400
Pulaski, TN 38478-4515
Phone
(931) 363-3086
NPI assigned
Mar 29, 2007
Last updated
Feb 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 061500 GA Primary
Internal Medicine Physician 207R00000X 0000050726 TN

Addresses

Primary practice location

1255 E College St
Suite 400
Pulaski, TN 38478-4515

Mailing address

1255 E College St
Suite 400
Pulaski, TN 38478-4515
Phone (931) 363-3086

Other identifiers 2

IdentifierTypeStateIssuer
166171001MedicaidAR
5H022OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140624002591 TN Practitioner - Internal Medicine 6103912092 Reassigns benefits to 1 organization
I20180503001262 TX Practitioner - Internal Medicine 6103912092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

RR 5 Box
Suite 840
Stilwell, OK 74960-9222
Phone (918) 696-8800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
061500GAMDInternal Medicine Physician
0000050726TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Apr 1, 2018 Accepting new patients
Amg-Hillside LLC Internal Medicine CurrentSince Apr 7, 2014 Accepting new patients
Cherokee Nation Current Accepting new patients
Amg-Hillside LLC CurrentSince Apr 7, 2014 Accepting new patients
Cherokee Nation Current Accepting new patients
Amg-Hillside LLC Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Apr 1, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Past Accepting new patients
Tanner Medical Group Inc Internal Medicine PastSince Feb 1, 2016 Accepting new patients
Forrest City Clinic Company LLC Internal Medicine Past Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

821 Amohi Ln
Salina, OK 74365
Phone (918) 390-4680

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

1255 E College St
Ste 400
Pulaski, TN 38478
Phone (931) 766-0077

204 Hillside Dr
Pulaski, TN 38478
Phone (931) 363-3514

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1607/brand/1/csg/1/fhir/r4

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1417076290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 E COLLEGE ST",
            "address_2": "SUITE 400",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784515",
            "telephone_number": "931-363-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 E COLLEGE ST",
            "address_2": "SUITE 400",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784515",
            "telephone_number": "931-363-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRETT",
        "middle_name": "ARIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "061500",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "0000050726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166171001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5H022",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, TN

Sources for this page

Verify at the official NPI Registry.