NPIMap

Organization Active NPI

Jay Walter Nielsen MD Inc

Doing business as Spine and Joint Care Inc

  • Adult Medicine Physician
  • Maumee, OH
National Provider Identifier
1972784825
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
35-04-0332-N Issued in OH
Legal business name
JAY WALTER NIELSEN MD INC
Doing business as
Spine and Joint Care Inc
Practice address
1900 Indian Wood Cir
Suite 100
Maumee, OH 43537-4033
Phone
(419) 897-6490
Fax
(419) 897-0544
NPI assigned
Nov 20, 2007
Last updated
Jun 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Jay W Nielsen, MDNPI 1982775268
Title
Owner
Phone
(419) 897-6490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 35-04-0332-N OH Primary

Addresses

Primary practice location

1900 Indian Wood Cir
Suite 100
Maumee, OH 43537-4033

Mailing address

1900 Indian Wood Cir
Suite 100
Maumee, OH 43537-4033
Phone (419) 897-6490

Other identifiers 1

IdentifierTypeStateIssuer
0419158MedicaidOH

Other names 1

  • Spine and Joint Care Inc Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1972784825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 INDIAN WOOD CIR",
            "address_2": "SUITE 100",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374033",
            "telephone_number": "419-897-6490",
            "fax_number": "419-897-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 INDIAN WOOD CIR",
            "address_2": "SUITE 100",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374033",
            "telephone_number": "419-897-6490",
            "fax_number": "419-897-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY WALTER NIELSEN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-897-6490",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "35-04-0332-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0419158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine and Joint Care Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.