Individual provider Active NPI

Clint Reid Nelson, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Salt Lake City, UT
National Provider Identifier
1629221981
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
7148526-1205 Issued in UT
Practice address
50 Mario Capecchi Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Oct 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 7148526-1205 UT
Neurology Physician 2084N0400X 7148526-1205 UT
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 7148526-1205 UT Primary

Addresses

Primary practice location

50 Mario Capecchi Dr
Salt Lake City, UT 84132-0001

Mailing address

3226 Davencourt Cir
Lehi, UT 84043-4544
Phone (801) 361-3961

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cnelson6416@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20150414001469 UT Practitioner - NeurologyPractitioner - Pediatric Medicine 8224356761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Baylor College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Pediatric ServicesGroup PAC ID 0547552473, 129 clinicians

Practice addresses (Care Compare)

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 213-3599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 24, 2018 Accepting new patients
University of Utah Pediatric Services CurrentSince Sep 30, 2022 Accepting new patients
University of Utah Pediatric Services Pediatrics CurrentSince Sep 30, 2022 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
Ihc Health Services Inc CurrentSince Nov 24, 2018 Accepting new patients
University of Utah Pediatric Services Pediatrics Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

2250 N Miller Campus Dr
Lehi, UT 84048
Phone (385) 531-1000

395 W Cougar Blvd
Ste 702
Provo, UT 84604
Phone (801) 357-1700

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1380 E Medical Center Dr
Ste 3100
St George, UT 84790
Phone (435) 251-2740

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1629221981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 DAVENCOURT CIR",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840434544",
            "telephone_number": "801-361-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CLINT",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "7148526-1205",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "7148526-1205",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "UT",
            "license": "7148526-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnelson6416@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.