John Arthur Nelson, CPNP, PHD

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F380811 Issued in NY

Practice address

21 Audubon Avenue
New York, NY 10032

Phone

(212) 342-3207

NPI assigned

Mar 19, 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)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy

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.

• Catskill Regional Medical Center

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1669596078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274426",
            "telephone_number": "646-284-9727",
            "fax_number": "646-284-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AUDUBON AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-342-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JOHN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "CPNP, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BILLING ID #",
            "identifier": "15210N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Nelson
• Howard Nelson, PT
• Irina Nelson
• Jan Lee Nelson, LCSW
• Jennifer L Nelson, LMHC
• John D Nelson, DDS
• Jonas Allan Nelson, MD
• Joshua Nelson, PH.D.
• Joshua Nelson, L.AC.
• Judith E Nelson, MD

• Pediatric Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.