Roger E Nellans, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD28212 Issued in OR

Practice address

1739 E Beverly Ave
Suite 101
Kingman, AZ 86409-3593

Phone

(928) 681-8686

Fax

(928) 681-8690

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1487742201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 BEVERLY AVE",
            "address_2": "SUITE 101",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-681-8686",
            "fax_number": "928-681-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE",
            "address_2": "SUITE 101",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8686",
            "fax_number": "928-681-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLANS",
        "first_name": "ROGER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "15152",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OR",
            "license": "MD28212",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "33271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nationwide Optometry P.C.
• Nirupama Nayudu
• Nazcare - New Directions Wellness Center
• Heather Ann Neal, PA-C
• Tabitha Lee Ann Neal
• Donald H Nelson, DO
• Dorothy Denise Nelson, LCSW
• Stacy Nelson, RN
• Tosha Nelson
• Neurological & Headache Disorders PC

• Urology Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.