NPIMap

Individual provider Active NPI

Lawrence Nelson, DO

  • Trauma Surgery Physician
  • Machesney Park, IL
National Provider Identifier
1427035534
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
036-089481 Issued in IL
Practice address
8103 Burden Rd
Machesney Park, IL 61115-8208
Phone
(815) 713-2600
Fax
(815) 654-8020
NPI assigned
Dec 29, 2005
Last updated
Jun 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36089481 IL
Trauma Surgery Physician 2086S0127X 036-089481 IL Primary

Addresses

Primary practice location

8103 Burden Rd
Machesney Park, IL 61115-8208

Mailing address

8103 Burden Rd
Machesney Park, IL 61115-8208
Phone (815) 713-2600

Other identifiers 2

IdentifierTypeStateIssuer
P00470671OtherILRAILROAD MEDICARE
4673170001OtherILDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, 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
I20050202000908 WI Practitioner - General Surgery 2163482878 Reassigns benefits to 1 organization
I20170210000699 TX Practitioner - General Surgery 2163482878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone (361) 881-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36089481ILMDFamily Medicine Physician
036-089481ILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 3, 2017 Accepting new patients
Beaver Dam Community Hospitals Inc Family Medicine CurrentSince Feb 3, 2017 Accepting new patients
Lawrence E Nelson DO PLLC CurrentSince Nov 15, 2016 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients
Trauma and Surgical Specialists of Dupage, LLC Trauma Surgery PastSince Jan 1, 2007 Accepting new patients
Physicians Immediate Care North Chicago LLC PastSince Jan 19, 2025 Accepting new patients
Bronson Methodist Hospital Trauma Surgery Past Accepting new patients
Physicians Immediate Care LTD Past Accepting new patients
Christus Spohn Health System Corporation Past Accepting new patients
Specialty Physicians of Illinois, LLC PastSince Mar 5, 2023 Accepting new patients

Locations

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

Interoperability endpoints

  • Direct secure messaging: lnelson254316@christushealth.direct-ci.net

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1427035534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8103 BURDEN RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611158208",
            "telephone_number": "815-713-2600",
            "fax_number": "815-654-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8103 BURDEN RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611158208",
            "telephone_number": "815-713-2600",
            "fax_number": "815-654-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAWRENCE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36089481",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036-089481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00470671",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4673170001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

Verify at the official NPI Registry.