Active NPI
Joel B Nelson, DPM
- Podiatrist
- Canton, OH
National Provider Identifier
1689684532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 36002790N
- Practice address
- 733 Market Ave S
Canton, OH 44702-2165 - Phone
- (330) 489-4600
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 36002790N | OH | Primary |
Addresses
Primary practice location
733 Market Ave S
Canton, OH 44702-2165
Mailing address
733 Market Ave S
Canton, OH 44702-2165
Phone (330) 489-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120410000455 | OH | Order and Referring Only - Podiatry | 5395906895 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002790N | OH | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235606400000",
"number": "1689684532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "733 MARKET AVE S",
"city": "CANTON",
"state": "OH",
"postal_code": "447022165",
"telephone_number": "330-489-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "733 MARKET AVE S",
"city": "CANTON",
"state": "OH",
"postal_code": "447022165",
"telephone_number": "330-489-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JOEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2009-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OH",
"license": "36002790N",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.