Edward Reese Nelson Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D8364 Issued in TX

Practice address

1275 W. Terrell Ave
Ste 200
Fort Worth, TX 76104-2822

Phone

(817) 250-7035

NPI assigned

Jun 12, 2006

Last updated

Aug 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1639111883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CLEARFORK MAIN ST STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093559",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W. TERRELL AVE",
            "address_2": "STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042822",
            "telephone_number": "817-250-7035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 5th Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761047300",
            "country_code": "US",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5450 Clearfork Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761093559",
            "country_code": "US",
            "telephone_number": "817-334-1400",
            "fax_number": "817-334-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "EDWARD",
        "middle_name": "REESE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D8364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127910103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127910106",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ambrosia Nelson, RBT
• Audrey Raquel Nelson, PA
• Catherine Nelson, M.S. CF-SLP
• Dehija Nelson
• Derek Dee Nelson, D.C.
• Hattie Hoskins Nelson, NP
• Kim Leslie Nelson, DDS
• Marian K Nelson, CRNA
• Mark J Nelson, M.D.
• Michael Adam Nelson, EMTP

• Internal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.