Individual provider Active NPI

Jacob Thomas Nelson, PA-C

  • Physician Assistant
  • Bettendorf, IA
National Provider Identifier
1437992385
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
136853 Issued in IA
Practice address
5250 Competition Dr Ste 100
Bettendorf, IA 52722-8837
Phone
(563) 322-0971
Fax
(563) 324-0615
NPI assigned
Jun 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085012038 IL
Physician Assistant 363A00000X 136853 IA Primary

Addresses

Primary practice location

5250 Competition Dr Ste 100
Bettendorf, IA 52722-8837

Mailing address

5250 Competition Dr Ste 100
Bettendorf, IA 52722-8837
Phone (563) 322-0971

Other practice location 1

520 Valley View Dr
Moline, IL 61265-6194
Phone (309) 762-3621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260209003860 IA Practitioner - Physician Assistant 2860971967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ora Orthopedics PCGroup PAC ID 6406741784, 119 clinicians

Practice addresses (Care Compare)

6101 Northwest Blvd
Davenport, IA 52806-1861
Phone (563) 322-0971

Hospital & facility affiliations

  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ora Orthopedics, PC CurrentSince Jan 20, 2026 Accepting new patients
Ora Orthopedics PC CurrentSince Jan 20, 2026 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

2300 53rd Ave
Ste 100
Bettendorf, IA 52722
Phone (563) 459-4005

2300 53rd Ave
Ste LL04
Bettendorf, IA 52722

5250 Competition Dr
Ste 100
Bettendorf, IA 52722
Phone (563) 449-7000

1414 W Lombard St
Davenport, IA 52804
Phone (563) 326-6431

6101 Northwest Blvd
Davenport, IA 52806
Phone (563) 449-7004

520 Valley View Dr
Moline, IL 61265
Phone (309) 762-1952

985 Avenue of the Cities
Ste 105
Silvis, IL 61282
Phone (309) 762-3621

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1437992385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 COMPETITION DR STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527228837",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 COMPETITION DR STE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527228837",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Valley View Dr",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656194",
            "country_code": "US",
            "telephone_number": "309-762-3621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085012038",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "136853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.