Individual provider Active NPI

Perry Vincent Nelson, MD

  • Internal Medicine Physician
  • Springfield, OR
National Provider Identifier
1609803774
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD24573 Issued in OR
Practice address
Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803
Phone
(412) 226-3893
Fax
(541) 222-6385
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2013-00010 NC
Hospitalist Physician 208M00000X MD24573 OR
Internal Medicine Physician 207R00000X MD24573 OR Primary

Addresses

Primary practice location

Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803

Mailing address

Peacehealth Hospital Medicine
3377 Riverbend Drive
Springfield, OR 97477-8803
Phone (412) 226-3893

Other practice location 1

181 Daniel Rd
Forest City, NC 28043-7151
Phone (828) 286-9036

Other identifiers 3

IdentifierTypeStateIssuer
278100MedicaidOR
1609803774MedicaidNC
NC2126MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20050912000395 OR Practitioner - Internal Medicine 3971536905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

2801 NW Mercy Dr
Suite 350
Roseburg, OR 97471-2349
Phone (541) 222-2700

3311 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7218

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300

3355 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6113

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24573ORMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Hospitalist CurrentSince Oct 12, 2015 Accepting new patients
Firstcare Medical Foundation Internal Medicine PastSince Sep 1, 2004 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients

Locations

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1689552000000",
    "number": "1609803774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH HOSPITAL MEDICINE",
            "address_2": "3377 RIVERBEND DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "412-226-3893",
            "fax_number": "541-222-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH HOSPITAL MEDICINE",
            "address_2": "3377 RIVERBEND DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "412-226-3893",
            "fax_number": "541-222-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Daniel Rd",
            "address_purpose": "LOCATION",
            "city": "Forest City",
            "state": "NC",
            "postal_code": "280437151",
            "country_code": "US",
            "telephone_number": "828-286-9036",
            "fax_number": "828-286-1079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PERRY",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-00010",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD24573",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD24573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278100",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609803774",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2126",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.