Jared William Nelson, MD

Key facts

NPI

1528034980

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

MD60272838 (WA)

Practice address

2207 N Molter Rd Ste 203
Liberty Lake, WA 99019-7571

Phone

(509) 348-2214

Fax

(509) 903-0040

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Liberty Lake Direct Primary Care PLLC Family Medicine Physician · Liberty Lake, WA · NPI 1558048280
  NPD Authorized official FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 5, 2026.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1528034980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 N MOLTER RD STE 203",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197571",
            "telephone_number": "509-348-2214",
            "fax_number": "509-902-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 N MOLTER RD STE 203",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197571",
            "telephone_number": "509-348-2214",
            "fax_number": "509-903-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JARED",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60272838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287973",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

• Susan J Naccarato, DC
• Jennifer Anne Nakata, NP
• Amber M Napier, LMT
• Ruth Nassen
• Neighborhood Care, LLC
• Emmylou T Newell, RDN
• Tammy Nixon-Potts, RPH
• North Idaho Day Surgery LLC
• Npology LLC
• NRS Arizona, PA

All providers in Liberty Lake, WA · Family Medicine Physician in Washington