Active NPI
Mark Steven Nelson, LMSW
- Social Worker
- Burley, ID
National Provider Identifier
1861765992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-31713
- Practice address
- 2311 Park Ave
Unit 2 Suite 8
Burley, ID 83318-2170 - Phone
- (208) 878-3350
- NPI assigned
- Feb 21, 2012
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-31713 | ID | Primary |
Addresses
Primary practice location
2311 Park Ave
Unit 2 Suite 8
Burley, ID 83318-2170
Mailing address
238 Avenida del Rio Dr
Twin Falls, ID 83301-9276
Phone (208) 733-9799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1861765992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 AVENIDA DEL RIO DR",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833019276",
"telephone_number": "208-733-9799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2311 PARK AVE",
"address_2": "UNIT 2 SUITE 8",
"city": "BURLEY",
"state": "ID",
"postal_code": "833182170",
"telephone_number": "208-878-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MARK",
"middle_name": "STEVEN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-31713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.