Active NPI
Nicholas Charles Nelson, DO
- Pediatrics Physician
- Clovis, CA
National Provider Identifier
1831883883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A25909
- Practice address
- 2126 Shaw Ave
Clovis, CA 93611-8919 - Phone
- (559) 387-2150
- Fax
- (559) 387-2155
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A25909 | CA | Primary |
Addresses
Primary practice location
2126 Shaw Ave
Clovis, CA 93611-8919
Mailing address
PO Box 889442
Los Angeles, CA 90088-9442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230721000299 | KS | Order and Referring Only - Pediatric Medicine | 0941660054 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-11443 | KS | MD | Pediatrics Physician |
Interoperability endpoints
- nicholas.nelson@hca3.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1831883883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 889442",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900889442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2126 SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936118919",
"telephone_number": "559-387-2150",
"fax_number": "559-387-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "NICHOLAS",
"middle_name": "CHARLES",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-05",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A25909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.