Individual provider Active NPI

Matthew Nelson, M.A., SLP

  • Speech-Language Pathologist
  • Des Moines, IA
National Provider Identifier
1942629928
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
002309 Issued in IA
Practice address
4725 Merle Hay Rd Ste 107
Des Moines, IA 50322-1983
Phone
(515) 331-3190
NPI assigned
Apr 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 002309 IA Primary

Addresses

Primary practice location

4725 Merle Hay Rd Ste 107
Des Moines, IA 50322-1983

Mailing address

1450 Office Park Rd
Apt 200
West Des Moines, IA 50265-2496
Phone (712) 229-1266

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
002309IAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1942629928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 OFFICE PARK RD",
            "address_2": "APT 200",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652496",
            "telephone_number": "712-229-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 MERLE HAY RD STE 107",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221983",
            "telephone_number": "515-331-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "credential": "M.A., SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "002309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.

Verify at the official NPI Registry.