Individual provider Active NPI

Michael L Nelson, DPM

  • Podiatrist
  • Spanish Fork, UT
National Provider Identifier
1710909122
Registry record updated Sep 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
367775-0501 Issued in UT
Practice address
65 W 200 N
Suite1
Spanish Fork, UT 84660-1756
Phone
(801) 794-3856
Fax
(801) 794-9882
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 367775-0501 UT Primary

Addresses

Primary practice location

65 W 200 N
Suite1
Spanish Fork, UT 84660-1756

Mailing address

65 W 200 N
Suite1
Spanish Fork, UT 84660-1756
Phone (801) 794-3856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116001220 UT Practitioner - Podiatry 1355305665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

65 W 200
Suite 5
Spanish Fork, UT 84660-1774
Phone (801) 794-3856

65 W 200 N
Suite 5
Spanish Fork, UT 84660-1756

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue21
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1710909122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W 200 N",
            "address_2": "SUITE1",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601756",
            "telephone_number": "801-794-3856",
            "fax_number": "801-794-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W 200 N",
            "address_2": "SUITE1",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601756",
            "telephone_number": "801-794-3856",
            "fax_number": "801-794-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "367775-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

Verify at the official NPI Registry.