Active NPI
James M Nelson, O.D.
- Optometrist
- Muskogee, OK
National Provider Identifier
1912948175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2019
- Practice address
- 3101 Chandler Rd
Suite 105
Muskogee, OK 74403-4954 - Phone
- (918) 683-1021
- Fax
- (918) 683-3347
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2019 | OK | Primary |
Addresses
Primary practice location
3101 Chandler Rd
Suite 105
Muskogee, OK 74403-4954
Mailing address
3101 Chandler Rd
Suite 105
Muskogee, OK 74403-4954
Phone (918) 683-1021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100765570A | Medicaid | OK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019 | OK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Om Tahlequah, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Contractor
- Muskogee, OK
- NPI 1437264587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428364800000",
"number": "1912948175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 CHANDLER RD",
"address_2": "SUITE 105",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744034954",
"telephone_number": "918-683-1021",
"fax_number": "918-683-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 CHANDLER RD",
"address_2": "SUITE 105",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744034954",
"telephone_number": "918-683-1021",
"fax_number": "918-683-3347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JAMES",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2015-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "2019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100765570A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.