Individual provider Active NPI

W. Michael Nelson III, PHD

  • Clinical Psychologist
  • Cincinnati, OH
National Provider Identifier
1497811913
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2734 Issued in OH
Practice address
Department of Psychlogy, Xavier University
3800 Victory Parkway
Cincinnati, OH 45207-6411
Phone
(513) 745-3298
Fax
(513) 745-4380
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2734 OH Primary

Addresses

Primary practice location

Department of Psychlogy, Xavier University
3800 Victory Parkway
Cincinnati, OH 45207-6411

Mailing address

Department of Psychology, Xavier Universtiy
3800 Victory Parkway
Cincinnati, OH 45207-6411
Phone (513) 745-3298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2734OHMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497811913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHOLOGY, XAVIER UNIVERSTIY",
            "address_2": "3800 VICTORY PARKWAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452076411",
            "telephone_number": "513-745-3298",
            "fax_number": "513-745-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHLOGY, XAVIER UNIVERSITY",
            "address_2": "3800 VICTORY PARKWAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452076411",
            "telephone_number": "513-745-3298",
            "fax_number": "513-745-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "W.",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "2734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • 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.