Individual provider Active NPI

David Brian Nelson, M.D.

  • General Practice Physician
  • Rock Hill, SC
National Provider Identifier
1760441240
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22281 Issued in SC
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1437370657OtherGROUP NPI
201017243OtherSCFEDERAL TAX ID
GP4138MedicaidSC
22281OtherSCSC 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000028 SC Practitioner - Ophthalmology 5294784757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Hill Eye Clinic, P.a. Ophthalmology PastSince Jul 17, 1995 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.

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

Verify at the official NPI Registry.