Active NPI
Carroll A Nelson, PHARM D
- Pharmacist
- West Des Moines, IA
National Provider Identifier
1679523948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20241
- Practice address
- 1080 Jordan Creek Pkwy Ste 100
West Des Moines, IA 50266-6004 - Phone
- (515) 346-9672
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20241 | IA | Primary |
Addresses
Primary practice location
1080 Jordan Creek Pkwy Ste 100
West Des Moines, IA 50266-6004
Mailing address
110 Boulder Pointe
Polk City, IA 50226-1076
Phone (515) 710-6381
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20241 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1679523948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BOULDER POINTE",
"city": "POLK CITY",
"state": "IA",
"postal_code": "502261076",
"telephone_number": "515-710-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1080 JORDAN CREEK PKWY STE 100",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502666004",
"telephone_number": "515-346-9672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CARROLL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.