Michael John Nelson, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

00039405 Issued in WA

Practice address

501 SE 172ND Ave Ste 220
Vancouver, WA 98684-9542

Phone

(360) 882-2778

Fax

(360) 604-1734

NPI assigned

May 3, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Neurology

Education

University of Missouri, Columbia School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mnelson12307@tvc-direct.org

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.

• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment Care Compare group NPD
• Diablo Neurology Inc.

  • Neurology Physician
  • Washougal, WA
  • NPI 1982910295
  NPD (past) Authorized official
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Pharmacy

  • Pharmacist
  • Vancouver, WA
  • NPI 1336365857
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1528026051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "585 W Lookout Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Washougal",
            "state": "WA",
            "postal_code": "986717595",
            "country_code": "US",
            "telephone_number": "925-299-9022",
            "fax_number": "925-299-9024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A78283",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "00039405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Donaldson Nelson, D.M.D.
• Dwight L Nelson, BC-HIS
• Howard A Nelson, MD
• Joshua Herbert Nelson, M.D.
• Lyle Wilfred Nelson, M.D.,D.M.D.
• Samantha Ashley Nelson
• Shannon Ann Nelson, PTA
• Siera Krstine Nelson
• Stephen Brooks Nelson, MSW
• Travis L. Nelson

• Neurology Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.