Individual provider Active NPI

David K Nelson, LCSW-R

  • Clinical Social Worker
  • Ogdensburg, NY
National Provider Identifier
1497874812
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R079315 Issued in NY
Practice address
214 King St
Ogdensburg, NY 13669-1142
Phone
(315) 713-5720
Fax
(315) 713-5741
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R079315 NY Primary

Addresses

Primary practice location

214 King St
Ogdensburg, NY 13669-1142

Mailing address

8101 State Highway 68
Ogdensburg, NY 13669-4403
Phone (315) 541-3042

Other identifiers 1

IdentifierTypeStateIssuer
03182083MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000242 NY Practitioner - Clinical Social Worker 2769636703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R079315NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Helpers Care Inc CurrentSince Aug 1, 2024 Accepting new patients
United Helpers Care Inc CurrentSince Aug 1, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1497874812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 STATE HIGHWAY 68",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136694403",
            "telephone_number": "315-541-3042",
            "fax_number": "315-541-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 KING ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691142",
            "telephone_number": "315-713-5720",
            "fax_number": "315-713-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R079315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03182083",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

Verify at the official NPI Registry.