Individual provider Active NPI

Anastasia T Nelson, M.D.

  • Pediatrics Physician
  • Birmingham, AL
National Provider Identifier
1548647407
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35288 Issued in AL
Practice address
3729 Mary Taylor Road
Birmingham, AL 35235
Phone
(205) 856-4440
Fax
(205) 856-4445
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35288 AL Primary

Addresses

Primary practice location

3729 Mary Taylor Road
Birmingham, AL 35235

Mailing address

3729 Mary Taylor Road
Birmingham, AL 35235
Phone (205) 856-4440

Other identifiers 1

IdentifierTypeStateIssuer
223455MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20160919002594 AL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6507153517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35288ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tots 'N' Teens Pediatrics, P.C. Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1548647407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 MARY TAYLOR ROAD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-856-4440",
            "fax_number": "205-856-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 MARY TAYLOR ROAD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-856-4440",
            "fax_number": "205-856-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANASTASIA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "35288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223455",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.