Larry R. Nelson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

252-9 0013431 Issued in WA

Practice address

1800 Cooks Hill Rd
Centralia, WA 98531-9072

Phone

(360) 736-0713

Fax

(360) 330-8680

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801814892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MARVIN RD NE",
            "address_2": "SUITE 307 PMB 266",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165709",
            "telephone_number": "360-491-5055",
            "fax_number": "360-491-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-736-0713",
            "fax_number": "360-330-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LARRY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "252-9 0013431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I WORKERS COMP",
            "identifier": "14818",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1625003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "L00240",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melia Rose Napahuelua-Baker, BS, R-AAC
• Becky Yvonne Nederlander
• Lisa Neff, DO
• Mikhail Pavlovich Nekhamis, CRNA
• Aaron Ward Neldon
• Matthew Nelson, PHARMD
• Pamela Yvonne Nelson
• Ryan Thomas Nelson
• Amanda Jo Nevitt, AAC
• Alexander Newberry

• Internal Medicine Physician in Centralia, WA
• Providers in Centralia, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.