Robert C Nelson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1210 Issued in SC

Practice address

5617 Maxwell PL
Wilmington, NC 28409-2966

Phone

(910) 742-9243

Fax

(888) 746-1787

NPI assigned

Oct 4, 2006

Last updated

Sep 22, 2013By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charleston Counseling Center PC

  dba Lifestance Health

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678
  Medicare reassignment Care Compare group NPD
• Che Behavioral Health Services of South Carolina, P.C.

  • Clinical Psychologist
  • Greenville, SC
  • NPI 1568048833
  Medicare reassignment NPD
• Lifesource of North Carolina

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1811286156

  Clinical

  NPD (past)
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379808000000",
    "number": "1730274713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16310",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284086310",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5617 MAXWELL PL",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284092966",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1210",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "RPS2002005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301100",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01126706",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0511",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nelson C Klaus Jr OD
• Ashley Marie Nelson, DO
• Jean Marie Nelson, MD
• Katherine Louise Nelson, LPCA
• Robert Nelson, PA-C
• Sarah Freeman Nelson, LCSWA, LCASA
• Hayley Alise Nemeth, LCSW
• Danielle Lauren Nerber, DO
• Kelly Foster Nerell, LPA
• Katherine Nethers

• Clinical Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.