Individual provider Active NPI

Eric John Nelson, MD

  • Cardiovascular Disease Physician
  • Cumming, GA
National Provider Identifier
1609838705
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
72993 Issued in GA
Practice address
3970 Deputy Bill Cantrell Memorial Rd
Suite 100
Cumming, GA 30040
Phone
(678) 513-2273
Fax
(678) 513-8869
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 230786 MA
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 72993 GA Primary

Addresses

Primary practice location

3970 Deputy Bill Cantrell Memorial Rd
Suite 100
Cumming, GA 30040

Mailing address

3970 Deputy Bill Cantrell Memorial Rd
Suite 100
Cumming, GA 30040
Phone (678) 513-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NorthsideHeart@Northside.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150420001956 GA Practitioner - Cardiovascular Disease (Cardiology) 9931204948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Massachusetts Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

1285 Upper Hembree Rd
Roswell, GA 30076-1143
Phone (770) 343-8565

433 Highland Pkwy
Suite 201
Ellijay, GA 30540-7658
Phone (404) 845-8200

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

470 Northside Cherokee Blvd
Canton, GA 30115-8029

5670 Peachtree Dunwoody Rd
Suite 880
Atlanta, GA 30342-4789
Phone (404) 256-2525

Hospital & facility affiliations

  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
67.82
Promoting interoperability
77
Improvement activities
40
Cost
77.43

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
72993GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Cardiovascular Professional Services, LLC Cardiovascular Disease CurrentSince Jun 9, 2018 Accepting new patients
North Atlanta Professional Services LLC Cardiovascular Disease CurrentSince Feb 1, 2016 Accepting new patients
Nmda Anesthesia LLC Past Accepting new patients

Locations

460 Northside Cherokee Blvd
Ste 150
Canton, GA 30115
Phone (470) 639-6250

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

433 Highland Pkwy
Ste 201
Ellijay, GA 30540
Phone (706) 253-5514

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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 4

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1609838705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTRELL MEMORIAL RD",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-513-2273",
            "fax_number": "678-513-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTRELL MEMORIAL RD",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-513-2273",
            "fax_number": "678-513-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "230786",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "72993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NorthsideHeart@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "3970 Deputy Bill Cantrell Memorial Rd",
            "address_2": "Suite 100",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.