Larry Ralph Nelson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00013912 Issued in WA

Practice address

809 S 15TH St
Mount Vernon, WA 98274-4564

Phone

(360) 428-6434

Fax

(360) 428-6485

NPI assigned

Apr 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477510493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S 15TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744564",
            "telephone_number": "360-428-6434",
            "fax_number": "360-428-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LARRY",
        "middle_name": "RALPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00013912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8167603",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• National Seating & Mobility, Inc.
• Yvonne Claudia Naughton, M.D.
• Danniell R. Naumann, L.M.P
• Brett Robert Nelson, P.T.
• Christopher Nelson, PHD
• Tim L Nelson, LMP
• Amanda Neuhauser
• Brandon David Nevi
• New Spine (Riverside chiropractic clinic)
• Thomas James Newcomer, PHARMD

• Emergency Medicine Physician in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.