Kimberly Fullerton Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A68026 Issued in CA

Practice address

2700 Dolbeer St
Eureka, CA 95501-4736

Phone

(707) 445-8121

NPI assigned

Jun 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1639800279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-445-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-445-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KIMBERLY",
        "middle_name": "FULLERTON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-05-22",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0068652",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A68026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin James Nelson, RN
• Chandel Nelson
• David Andrew Nelson, DMD
• Eric Helland Nelson, SAC
• John Christopher Nelson, M.D.
• Melissa Rose Nelson, B.A.
• Michael Nelson
• Savana Nelson
• Linda Parmentier Nesbitt, LCSW
• April Dawn Ness

• Family Medicine Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.