Sandra K Nelson, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

9486A Issued in WY

Practice address

424 Yellowstone Ave.
Ste 220
Cody, WY 82414

Phone

(307) 578-2500

Fax

(307) 578-2492

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snelson247624@direct.phs.org

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.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• West Park Hospital District

  • Multi-Specialty Clinic/Center
  • Cody, WY
  • NPI 1477192243
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1710071071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2500",
            "fax_number": "307-578-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 YELLOWSTONE AVE.",
            "address_2": "STE 220",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2500",
            "fax_number": "307-578-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "50611",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WY",
            "license": "9486A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34916000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IP805843700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000010029939",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTANA MEDICAID",
            "identifier": "35564",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "39859",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Murray
• John Murray, M.D.
• Dale R Myers, MD
• Kayla Nagle, PA-C
• Betsey Jean Neddermeyer, PA-C
• Brynn Neufer
• John Newton
• Rachel Nielsen, LCSW
• Cody Moncur Nielson, APRN, FNP-BC
• Elizabeth Norman, PHARMD

• Child & Adolescent Psychiatry Physician in Cody, WY
• Providers in Cody, WY by specialty
• Child & Adolescent Psychiatry Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.

Verify at the official NPI Registry.