Individual provider Active NPI

Claire Nelson, M.D.

  • Addiction Medicine (Preventive Medicine) Physician
  • Redlands, CA
National Provider Identifier
1447447776
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
A101635 Issued in CA
Practice address
1889 W Redlands Blvd Unit 9
Redlands, CA 92373-3119
Phone
(909) 501-5167
Fax
(909) 801-8133
NPI assigned
Oct 1, 2007
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A101635 CA
Public Health & General Preventive Medicine Physician 2083P0901X A101635 CA
Addiction Medicine (Preventive Medicine) Physician 2083A0300X A101635 CA Primary

Addresses

Primary practice location

1889 W Redlands Blvd Unit 9
Redlands, CA 92373-3119

Mailing address

24785 Stewart St Ste 204
Loma Linda, CA 92350-1721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151026001390 CA Practitioner - Preventive MedicinePractitioner - Other (Physician)Practitioner - Internal Medicine 7810206273 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101635CAMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Aug 18, 2015 Accepting new patients
County of San Bernardino Current Accepting new patients

Locations

303 E Mountain View St
Barstow, CA 92311
Phone (760) 256-4705

351 N Mountain View Ave
Rm 303
Sn Bernrdno, CA 92415

Interoperability endpoints

  • Direct secure messaging: cnelson83240@direct.llu.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1447447776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24785 STEWART ST STE 204",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 W REDLANDS BLVD UNIT 9",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733119",
            "telephone_number": "909-501-5167",
            "fax_number": "909-801-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CLAIRE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101635",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A101635",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A101635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.