Bradley Wimmer Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G52306 Issued in CA

Practice address

6405 Day St
Riverside, CA 92507-0901

Phone

(951) 697-5455

Fax

(951) 653-3975

NPI assigned

Nov 23, 2005

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

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1679556591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 ARLINGTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063912",
            "telephone_number": "951-782-5110",
            "fax_number": "951-274-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5455",
            "fax_number": "951-653-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRADLEY",
        "middle_name": "WIMMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP SITE LOCATION",
            "identifier": "ZZZ92058Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Nelch, APRN, FNP-C
• Michelle Olivia Nellon
• Nelson Lin D.D.S. Inc.
• Alex Nelson
• Ashley Marie Rose Nelson, LMFT
• Hailey Marie Nelson
• James E Nelson, MD
• Jennifer Marie Nelson, LMT
• Joseph Darryl Nelson, DPM
• Joshua Nelson

• Family Medicine Physician in Riverside, CA
• Providers in Riverside, 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 Dec 29, 2010; 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.