Active NPI
John Louis Nelson, O.D.
- Optometrist
- Castro Valley, CA
National Provider Identifier
1922095082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4985T
- Practice address
- 20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338 - Phone
- (510) 881-4401
- Fax
- (510) 881-4423
- NPI assigned
- Oct 4, 2005
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4985T | CA | Primary |
Addresses
Primary practice location
20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338
Mailing address
20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338
Phone (510) 881-4401
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 |
|---|---|---|---|
| 4985T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1922095082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20211 PATIO DR",
"address_2": "SUITE 100",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945464338",
"telephone_number": "510-881-4401",
"fax_number": "510-881-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20211 PATIO DR",
"address_2": "SUITE 100",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945464338",
"telephone_number": "510-881-4401",
"fax_number": "510-881-4423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JOHN",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4985T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.