Teresita Yap Nelson, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

009400594 Issued in NC

Practice address

12311 Copper Way
Suite 200
Charlotte, NC 28277-3642

Phone

(704) 541-8788

Fax

(704) 541-1069

NPI assigned

Apr 13, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Carolina Neurological Clinic, PA

  • Neurology Physician
  • Charlotte, NC
  • NPI 1902861396
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1699739136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602478",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602478",
            "telephone_number": "704-541-8788",
            "fax_number": "704-541-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 COPPER WAY",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773642",
            "telephone_number": "704-541-8788",
            "fax_number": "704-541-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TERESITA",
        "middle_name": "YAP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "009400594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8962092",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699739136",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Nelson
• Shaquill Nelson
• Sophire Marie Nelson
• Stephanie Nelson
• Tanna Nelson, MA, LPCA, NCC
• Thomas Richard Pierce Nelson, RBT
• Vaughn P Nelson, MD
• Virginia P. Nelson, FNP
• Tka Llarissa Joy Nembhard, APRN
• Neogenix, PC

• All providers in Charlotte, NC
• Neurology with Special Qualifications in Child Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.