Active NPI
David Brian Nelson, M.D.
- General Practice Physician
- Rock Hill, SC
National Provider Identifier
1760441240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 22281
- Practice address
- 410 S Herlong Ave
Suite 103
Rock Hill, SC 29732-8349 - Phone
- (803) 985-3937
- Fax
- (803) 985-3922
- NPI assigned
- Mar 22, 2006
- Last updated
- Aug 16, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 22281 | SC | |
| General Practice Physician | 208D00000X | 22281 | SC | Primary |
Addresses
Primary practice location
410 S Herlong Ave
Suite 103
Rock Hill, SC 29732-8349
Mailing address
410 S Herlong Ave
Suite 103
Rock Hill, SC 29732-8349
Phone (803) 985-3937
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437370657 | Other | GROUP NPI | |
| 201017243 | Other | SC | FEDERAL TAX ID |
| GP4138 | Medicaid | SC | |
| 22281 | Other | SC | SC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050124000028 | SC | Practitioner - Ophthalmology | 5294784757 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Hill Eye Clinic, P.a. | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Rock Hill, SC
- NPI 1437370657
-
- Ophthalmology Physician
- Rock Hill, SC
- NPI 1003873308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1760441240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 S HERLONG AVE",
"address_2": "SUITE 103",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297328349",
"telephone_number": "803-985-3937",
"fax_number": "803-985-3922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 S HERLONG AVE",
"address_2": "SUITE 103",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297328349",
"telephone_number": "803-985-3937",
"fax_number": "803-985-3922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "DAVID",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "22281",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "SC",
"license": "22281",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1437370657",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "201017243",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4138",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC LICENSE",
"identifier": "22281",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.