Individual provider Active NPI

Cory Oliver Nelson, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Scottsdale, AZ
National Provider Identifier
1790945228
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
41647 Issued in AZ
Practice address
8405 N Pima Center Pkwy Ste 101
Scottsdale, AZ 85258-4669
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Jun 9, 2008
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 41647 AZ
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 41647 AZ Primary

Addresses

Primary practice location

8405 N Pima Center Pkwy Ste 101
Scottsdale, AZ 85258-4669

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other identifiers 2

IdentifierTypeStateIssuer
430771MedicaidAZ
Z122854OtherPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090831000071 AZ Practitioner - Orthopedic Surgery 9537214499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
George Washington University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2940 E Banner Gateway Dr
Gilbert, AZ 85234-2168

5620 E Bell Rd
Scottsdale, AZ 85254-5950
Phone (602) 385-2115

8405 N Pima Ctr Pkwy
Suite 101
Scottsdale, AZ 85258-4638
Phone (602) 493-9361

9237 E Via de Ventura
Suite 103
Scottsdale, AZ 85258-3329
Phone (602) 648-5444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)28
Upper limb (arm) arthroscopy (minimally invasive joint repair)142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41647AZMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery CurrentSince Jan 12, 2011 Accepting new patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery Current Accepting new patients

Locations

16838 E Palisades Blvd
Ste C152
Fountain Hills, AZ 85268
Phone (480) 445-9199

3033 N 44th St
Ste 360
Phoenix, AZ 85018

20401 N 73rd St
Ste 175
Scottsdale, AZ 85255
Phone (480) 353-0446

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

8405 N Pima Center Pkwy
Ste 101
Scottsdale, AZ 85258
Phone (480) 353-0446

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1790945228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 N PIMA CENTER PKWY STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584669",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CORY",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "41647",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "41647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430771",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z122854",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.