Individual provider Active NPI

Howard L Nelson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Hagerstown, MD
National Provider Identifier
1811067952
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12507 Issued in MD
Practice address
1144 Opal Court
Hagerstown, MD 21740
Phone
(301) 733-2500
Fax
(301) 733-9600
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3550 WV
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12507 MD Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DEN5975 DC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS035393 PA

Addresses

Primary practice location

1144 Opal Court
Hagerstown, MD 21740

Mailing address

1007 Sushruta Drive
Martinsburg, WV 25401
Phone (304) 263-0991

Other identifiers 2

IdentifierTypeStateIssuer
4002163000MedicaidWV
DF52OtherMDBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040129000021 WV Practitioner - Oral Surgery 9234032145 Reassigns benefits to 1 organization
I20120907000590 MD Practitioner - Maxillofacial Surgery 9234032145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Howard University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Oral and Maxillofacial Surgeons, PCGroup PAC ID 1355243544, 3 clinicians

Practice addresses (Care Compare)

1007 Sushruta Dr
Martinsburg, WV 25401-8800
Phone 3042630991205

1144 Opal CT
Hagerstown, MD 21740-5940
Phone (301) 733-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN5975DCMDOral and Maxillofacial Surgery (Dentist)
12507MDMDOral and Maxillofacial Surgery (Dentist)
DS035393PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Oral & Maxillofacial Surgeons, PC Oral and Maxillofacial Surgery CurrentSince Oct 1, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6550 Mercantile Dr E
Ste 101
Frederick, MD 21703
Phone (301) 694-0870

198 Thomas Johnson Dr
Ste 101
Frederick, MD 21702
Phone (301) 694-0870

1144 Opal Ct
Hagerstown, MD 21740
Phone (301) 733-2500

1007 Sushruta Dr
Martinsburg, WV 25401
Phone (304) 263-0991

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1811067952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 SUSHRUTA DRIVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25401",
            "telephone_number": "304-263-0991",
            "fax_number": "304-274-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 OPAL COURT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-733-2500",
            "fax_number": "301-733-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "HOWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3550",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "12507",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN5975",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS035393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4002163000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "DF52",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.