Matthew Anson Nelson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6248-15 Issued in WI

Practice address

2805 Libal St
Suite a
Green Bay, WI 54301-2877

Phone

(920) 336-6062

NPI assigned

Jun 17, 2008

Last updated

Jun 17, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Parc Village Dental, LLC

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1386102465
  NPD (past)
• Steven R. Hein, DDS, SC

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1497915409
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1801057492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 LANSDALE LN",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151673",
            "telephone_number": "608-220-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 LIBAL ST",
            "address_2": "SUITE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012877",
            "telephone_number": "920-336-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "ANSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6248-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Louis Nelson I, PTA
• Joseph A Nelson, D.C.
• Kayley Nelson, DC
• Laura M Nelson, MD
• Lindsay M Nelson, DPT
• Megan Nelson, M.S., CCC-SLP
• Nicole Lynne Nelson, DNP, CRNA
• Rory M Nelson, MD
• Samantha Marie Nelson, ATC, LAC
• Sarah Nelson

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.

Verify at the official NPI Registry.