NPIMap

Individual provider Active NPI

Robert E. Nelson, M.D.

  • Psychiatry Physician
  • Wyomissing, PA
National Provider Identifier
1972696037
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD422537 Issued in PA
Practice address
2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone
(610) 378-9601
Fax
(610) 378-3610
NPI assigned
Oct 2, 2006
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X MD422537 PA
Psychiatry Physician 2084P0800X MD422537 PA Primary
Psychiatric Hospital 283Q00000X
Specialist 174400000X
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977

Mailing address

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone (610) 378-9601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031112000260 PA Practitioner - Psychiatry 5597678896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Duke University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DGR Management Inc.Group PAC ID 0941398184, 16 clinicians

Practice addresses (Care Compare)

2201 Ridgewood Rd
Suite 400
Wyomissing, PA 19610-1193
Phone (610) 378-9601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD422537PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group Single Specialty Current Accepting new patients
Tower Health Medical Group CurrentSince Dec 10, 2018 Accepting new patients
Tower Health Medical Group CurrentSince Dec 10, 2018 Accepting new patients
DGR Management Inc. Specialist CurrentSince Jul 1, 2007 Accepting new patients

Locations

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

2201 Ridgewood Rd
Ste 400
Wyomissing, PA 19610
Phone (610) 378-9601

560 Van Reed Rd
Ste 204
Wyomissing, PA 19610
Phone (610) 378-9601

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1972696037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "MD422537",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD422537",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.