Michael Brent Nelson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

54969 Issued in MN

Practice address

1630 Anderson Ave Ste 100
Whitesell Medical Staffing, LTD.
Buffalo, MN 55313-2946

Phone

(763) 682-5906

NPI assigned

Apr 14, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1821417353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 ANDERSON AVENUE SUITE 100",
            "address_2": "WHITESELL MEDICAL STAFFING, LTD.",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "55313",
            "telephone_number": "763-682-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 ANDERSON AVE STE 100",
            "address_2": "WHITESELL MEDICAL STAFFING, LTD.",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132946",
            "telephone_number": "763-682-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHAEL",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "54969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ann Mulligan
• Kendall Murray, P.T.
• Neisen Pain Clinic LLC
• Erin Elizabeth Nelson, NP-C
• Malinda Mary Nelson
• Jesse Nemgar
• Neve Inc (Avada Audiology & Hearing Care)
• Jacquelyn Newell, DNP, APRN, FNP-C
• Nextpass LLC
• Richard S Niedzielski, CRNA

• Family Medicine Physician in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.