Active NPI
Konner Gerrod Nelson, PSYD
- Clinical Psychologist
- Battle Creek, MI
National Provider Identifier
1891412524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0005975
- Practice address
- 5500 Armstrong Rd
Battle Creek, MI 49037-7314 - Phone
- (269) 966-5600
- NPI assigned
- Oct 24, 2022
- Last updated
- Oct 24, 2022
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY.0005975 | CO | Primary |
Addresses
Primary practice location
5500 Armstrong Rd
Battle Creek, MI 49037-7314
Mailing address
5500 Armstrong Rd
Battle Creek, MI 49037-7314
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0005975 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1891412524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 ARMSTRONG RD",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490377314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 ARMSTRONG RD",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490377314",
"telephone_number": "269-966-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KONNER",
"middle_name": "GERROD",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0005975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Battle Creek, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.