Active NPI
Nathaniel R. Nelson, DO
- Pediatrics Physician
- Sioux Falls, SD
National Provider Identifier
1780240622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- PENDING
- Practice address
- 1600 W 22ND St
Sioux Falls, SD 57105-1521 - Phone
- (605) 312-1000
- NPI assigned
- May 16, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | PENDING | SD | Primary |
Addresses
Primary practice location
1600 W 22ND St
Sioux Falls, SD 57105-1521
Mailing address
9005 Bridgewood Blvd Unit 6206
West Des Moines, IA 50266-8198
Phone (801) 898-1256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- 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 |
|---|---|---|---|---|
| I20190812003365 | SD | Order and Referring Only - Pediatric Medicine | 1355678418 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | SD | MD | Clinical Psychologist |
| 494 | SD | MD | Pediatric Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1780240622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9005 BRIDGEWOOD BLVD UNIT 6206",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502668198",
"telephone_number": "801-898-1256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W 22ND ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051521",
"telephone_number": "605-312-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "NATHANIEL",
"middle_name": "R.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SD",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.