Active NPI
Stephen Harold Nelson, DO
- Nephrology Physician
- Pittsfield, MA
National Provider Identifier
1962460634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 80111
- Practice address
- 777 North St
Renal Dialysis
Pittsfield, MA 01201 - Phone
- (413) 447-2764
- Fax
- (413) 447-2765
- NPI assigned
- May 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0320000487 | VT | |
| Nephrology Physician | 207RN0300X | 80111 | MA | Primary |
Addresses
Primary practice location
777 North St
Renal Dialysis
Pittsfield, MA 01201
Mailing address
725 North St
Pittsfield, MA 01201
Phone (413) 447-2752
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3128466 | Medicaid | MA |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0320000487 | VT | MD | Internal Medicine Physician |
| 80111 | MA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1962460634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 NORTH ST",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "01201",
"telephone_number": "413-447-2752",
"fax_number": "413-496-6836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 NORTH ST",
"address_2": "RENAL DIALYSIS",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "01201",
"telephone_number": "413-447-2764",
"fax_number": "413-447-2765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "STEPHEN",
"middle_name": "HAROLD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VT",
"license": "0320000487",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "80111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3128466",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.