Active NPI
Brian Nelson
- Mental Health Counselor
- Eagan, MN
National Provider Identifier
1669930012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 02165
- Practice address
- 3450 Oleary LN
Eagan, MN 55123-2340 - Phone
- (651) 454-0114
- NPI assigned
- Mar 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 02165 | MN | Primary |
Addresses
Primary practice location
3450 Oleary LN
Eagan, MN 55123-2340
Mailing address
3450 Oleary LN
Eagan, MN 55123-2340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02165 | MN | MD | Mental Health Counselor |
| 2249 | MN | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Eagan, MN
- NPI 1144311184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1669930012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 OLEARY LN",
"city": "EAGAN",
"state": "MN",
"postal_code": "551232340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 OLEARY LN",
"city": "EAGAN",
"state": "MN",
"postal_code": "551232340",
"telephone_number": "651-454-0114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "02165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.