Active NPI
Thomas Mark Nelson, MD
- Surgery Physician
- Duluth, MN
National Provider Identifier
1942251202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 34418
- Practice address
- 920 E 1St St
Suite P302
Duluth, MN 55805-2201 - Phone
- (218) 249-6050
- NPI assigned
- May 12, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 34418 | MN | Primary |
Addresses
Primary practice location
920 E 1St St
Suite P302
Duluth, MN 55805-2201
Mailing address
301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 225-3317
Other practice location 1
301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 225-3317
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020052636 | Other | MN | MEDICARE RR |
| 732708100 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tnelson179342@excellian.direct.allina.com | Direct |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34418 | MN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Hospital of Duluth | 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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Duluth, MN
- NPI 1073480968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1942251202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 HIGHWAY 65 S",
"city": "MORA",
"state": "MN",
"postal_code": "550511899",
"telephone_number": "320-225-3317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 E 1ST ST",
"address_2": "SUITE P302",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052201",
"telephone_number": "218-249-6050"
}
],
"practiceLocations": [
{
"address_1": "301 Highway 65 S",
"address_purpose": "LOCATION",
"city": "Mora",
"state": "MN",
"postal_code": "550511899",
"country_code": "US",
"telephone_number": "320-225-3317",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "THOMAS",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2021-03-02",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "34418",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "020052636",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "732708100",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tnelson179342@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "301 Highway 65 S",
"city": "Mora",
"state": "MN",
"country_code": "US",
"postal_code": "550511899",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.