Ian Nelson-Johnson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

092237 Issued in IA

Practice address

6649 Odana Rd
Madison, WI 53719-1011

Phone

(847) 736-2917

NPI assigned

Dec 16, 2016

Last updated

Apr 26, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nelson-Johnson Inc

  dba Ames Mind Body Center

  • Clinical Psychologist
  • Madison, WI
  • NPI 1669934121
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1598209033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6649 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191011",
            "telephone_number": "847-736-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6649 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191011",
            "telephone_number": "847-736-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON-JOHNSON",
        "first_name": "IAN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-16",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "092237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Nellen, DO
• Gregory Keith Nelligan, M.D.
• Robert Allen Nellis
• Nelson and Phipps Incorporated (Renewed Life Chiropractic)
• Nelson-Johnson Inc (Ames Mind Body Center)
• Sara Marie Nelson-Osterholz, D.C.
• Alysia Nelson
• Andrea Nelson, PH.D.
• Ariel Ann Nelson, M.D.
• Ashley Elizabeth Nelson, D.C.

• Clinical Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.