Jimmy K Nelson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1118 Issued in WY

Practice address

209 S 7TH St
Worland, WY 82401-3307

Phone

(307) 347-2544

Fax

(307) 347-2352

NPI assigned

Feb 7, 2007

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Worland Dental Clinic, PC

  • General Practice Dentistry
  • Worland, WY
  • NPI 1326059791
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639219728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 WILSON DR",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824019503",
            "telephone_number": "307-347-2974",
            "fax_number": "307-347-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S 7TH ST",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013307",
            "telephone_number": "307-347-2544",
            "fax_number": "307-347-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JIMMY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "301685",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan K Mickelson, PH.D.
• Nathan David Miller
• Erin C Morgan, LPC
• Mountain West Eye Care P.C.
• Tom Musgrove
• Randy Newton
• North Big Horn Hospital District (Worland Health and Rehabilitation)
• Northwest Community Action Programs of Wyoming, Inc.
• Diane L. Noton, MD
• Nugent Ventures LLC

• General Practice Dentistry in Worland, WY
• Providers in Worland, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.