Shane Aaron Nelson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7117 Issued in KS

Practice address

7001 W 121St St
Overland Park, KS 66209-2009

Phone

(913) 313-8428

Fax

(913) 906-0800

NPI assigned

Feb 21, 2006

Last updated

Jul 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 16, 2020 through Jan 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1619942083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14973 OUTLOOK LN",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232931",
            "telephone_number": "913-302-1478",
            "fax_number": "913-897-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 W 121ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092009",
            "telephone_number": "913-313-8428",
            "fax_number": "913-906-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHANE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19850",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016000952",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "7117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine E Nelson, DPT
• Krystal Danielle Nelson, COTA
• Laura Lee Nelson, P.T.
• Nancy Nelson, LMSW
• Rebecca Ann Nelson, OTR
• Hayley Nemec
• Matthew Joseph Nemero, DO
• Neowellnez LLC
• Amanda Lou Nester
• Chelsea Leigh Nettle, ATC

• General Practice Dentistry in Overland Park, KS
• Providers in Overland Park, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.