Active NPI
Douglas T Nelsen, MD
- Emergency Medical Services (Emergency Medicine) Physician
- Port Townsend, WA
National Provider Identifier
1609803600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- MD00027873
- Practice address
- 834 Sheridan St
Port Townsend, WA 98368-2443 - Phone
- (360) 385-1252
- Fax
- (360) 335-1252
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | MD00027873 | WA | Primary |
Addresses
Primary practice location
834 Sheridan St
Port Townsend, WA 98368-2443
Mailing address
505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1081NE | Other | WA | BSWA |
| 8153439 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Physician Associates, Apc | Past | Accepting new patients | |
| Cedra Emergency Physicians LLC | Past | Accepting new patients |
Interoperability endpoints
- douglas.nelsen.p1@direct.pgsklallamtribe.nextgenshare.com
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Sedro Woolley, WA
- NPI 1942500749
-
- Emergency Medicine Physician
- Federal Way, WA
- NPI 1407127442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1609803600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S 336TH ST",
"address_2": "SUITE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036328",
"telephone_number": "253-838-6180",
"fax_number": "253-838-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 SHERIDAN ST",
"city": "PORT TOWNSEND",
"state": "WA",
"postal_code": "983682443",
"telephone_number": "360-385-1252",
"fax_number": "360-335-1252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSEN",
"first_name": "DOUGLAS",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "WA",
"license": "MD00027873",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "1081NE",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8153439",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Townsend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.