NPIMap

Individual provider Active NPI

Nathaniel Thomas Nielsen, DO

  • Family Medicine Physician
  • Liberty, MO
National Provider Identifier
1427540327
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023031789 Issued in MO
Practice address
2609 Glenn Hendren Dr
Liberty, MO 64068-3313
Phone
(816) 781-7730
NPI assigned
Jun 6, 2018
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29186 MN
Family Medicine Physician 207Q00000X 66368 MN
Family Medicine Physician 207Q00000X 2023031789 MO Primary

Addresses

Primary practice location

2609 Glenn Hendren Dr
Liberty, MO 64068-3313

Mailing address

2609 Glenn Hendren Dr
Liberty, MO 64068-3313
Phone (816) 781-7730

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920002183 MO Practitioner - Family Practice 6002165743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Liberty Hospital CorporationGroup PAC ID 9931166618, 135 clinicians

Practice addresses (Care Compare)

2609 Glenn Hendren Dr
Liberty, MO 64068-3313
Phone (816) 781-7730

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66368MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Liberty Hospital Corporation Family Medicine CurrentSince Sep 25, 2023 Accepting new patients
New Liberty Hospital Coporation CurrentSince Sep 25, 2023 Accepting new patients
New Liberty Hospital Corporation Family Medicine Current Accepting new patients
New Liberty Hospital Coporation Family Medicine Past Accepting new patients

Locations

305 S Platte Clay Way
Kearney, MO 64060
Phone (816) 628-4409

2521 Glenn Hendren Dr
Ste 410
Liberty, MO 64068
Phone (816) 415-3437

2609 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 407-4555

Interoperability endpoints

  • Direct secure messaging: nathaniel.nielsonmd.p2@direct.nlhc.nextgenshare.com

Organizations & group practices 4

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 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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1427540327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683313",
            "telephone_number": "816-781-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683313",
            "telephone_number": "816-781-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "NATHANIEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "29186",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "66368",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023031789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.