Brian Roth Nelson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP.60682570 Issued in WA

Practice address

9631 N Nevada St
Spokane, WA 99218-1133

Phone

(509) 559-3100

NPI assigned

Jul 9, 2012

Last updated

Oct 11, 2022By 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

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Excelsior Family Medicine LLCGroup PAC ID 2567875065, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Excelsior Family Medicine LLC

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1275179483
  Medicare reassignment Care Compare group NPD
• Puyallup Tribal Health Authority

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1063455665
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1518222371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-559-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181133",
            "telephone_number": "509-559-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "middle_name": "ROTH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP.60682570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alannah Nelson, SUDP-T
• Amber L Nelson, MPT
• Andrea Nelson
• Blake Nelson, RPH
• Bradford A. Nelson, MD
• Brooke Nelson
• Bruce C. Nelson, MSW, LICSW
• Emelie Nelson, LMHCA
• Erik James Nelson, PHARMD
• Grace Katharine Nelson

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.