Active NPI
Marci M Nelson, M.D.
- Family Medicine Physician
- Edmonds, WA
National Provider Identifier
1629021043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00042464
- Practice address
- 21911 76TH Ave W
#110
Edmonds, WA 98026-7903 - Phone
- (425) 640-4950
- Fax
- (425) 640-4958
- NPI assigned
- May 18, 2006
- Last updated
- Oct 8, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00042464 | WA | Primary |
Addresses
Primary practice location
21911 76TH Ave W
#110
Edmonds, WA 98026-7903
Mailing address
21911 76TH Ave W
#110
Edmonds, WA 98026-7903
Phone (425) 640-4950
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8393597 | Medicaid | WA | |
| 4252PU | Other | WA | REGENCE BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mnelson1042691@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of California, San Diego School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918
Phone (425) 640-4950
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00042464 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Current | Accepting new patients | |
| Swedish Health Services | Family Medicine | Current | Accepting new patients |
Locations
21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000
21911 76th Ave W
Ste 110
Edmonds, WA 98026
Phone (425) 640-4950
21911 76th Ave W
Ste 204
Edmonds, WA 98026
Phone (425) 673-3380
13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700
2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364
800 5th Ave
Ste 600
Seattle, WA 98104
Interoperability endpoints
- mnelson1042691@wm.providencedirect.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Seattle, WA
- NPI 1831139724
-
- Physical Therapist
- Seattle, WA
- NPI 1619680840
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Regional Medical Center Everett
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
- General Acute Care Hospital
- Everett, WA
- NPI 1700037801
-
- General Acute Care Hospital
- Edmonds, WA
- NPI 1033107214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1629021043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21911 76TH AVE W",
"address_2": "#110",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267903",
"telephone_number": "425-640-4950",
"fax_number": "425-640-4958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21911 76TH AVE W",
"address_2": "#110",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267903",
"telephone_number": "425-640-4950",
"fax_number": "425-640-4958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MARCI",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00042464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8393597",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "4252PU",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mnelson1042691@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "21911 76th Ave W",
"address_2": "#110",
"city": "Edmonds",
"state": "WA",
"country_code": "US",
"postal_code": "980267903",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.