Active NPI
Nelson Dermatology, PLLC
- Dermatology Physician
- Gainesville, VA
National Provider Identifier
1992005375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- NELSON DERMATOLOGY, PLLC
- Practice address
- 13289 Gateway Center Dr # 27
Gainesville, VA 20155-2989 - Phone
- (703) 373-9870
- Fax
- (703) 656-4777
- NPI assigned
- Nov 1, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jennell Nelson, MD
- Title
- Owner
- Phone
- (703) 373-9870
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
13289 Gateway Center Dr # 27
Gainesville, VA 20155-2989
Mailing address
7371 Atlas Walk Way # 645
Gainesville, VA 20155-2992
Phone (703) 373-9870
Other practice location 1
3300 Gallows Rd
Falls Church, VA 22042-3300
Phone (703) 373-9870
Other practice location 2
400 Weldon St
Latrobe, PA 15650-1517
Phone (855) 337-6669
Other names 1
- Nelson Derm at Salon Lofts
National Provider Directory
National Provider DirectoryLocations
13289 Gateway Center Dr
#27
Gainesville, VA 20155
Phone (703) 373-9870
13289 Gateway Center Dr
Gainesville, VA 20155
Phone (703) 373-9870
8140 Ashton Ave
Ste 112
Manassas, VA 20109
Phone (703) 393-6366
7960 Donegan Dr
Ste 212
Manassas, VA 20109
7960 Donegan Dr
Ste 217
Manassas, VA 20109
Phone (703) 257-8090
Interoperability endpoints
- https://api.platform.athenahealth.com/15737/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708473600000",
"number": "1992005375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7371 ATLAS WALK WAY # 645",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201552992",
"telephone_number": "703-373-9870",
"fax_number": "703-656-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13289 GATEWAY CENTER DR # 27",
"city": "GAINESVILLE",
"state": "VA",
"postal_code": "201552989",
"telephone_number": "703-373-9870",
"fax_number": "703-656-4777"
}
],
"practiceLocations": [
{
"address_1": "3300 Gallows Rd",
"address_purpose": "LOCATION",
"city": "Falls Church",
"state": "VA",
"postal_code": "220423300",
"country_code": "US",
"telephone_number": "703-373-9870",
"fax_number": "703-656-4777",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 Weldon St",
"address_purpose": "LOCATION",
"city": "Latrobe",
"state": "PA",
"postal_code": "156501517",
"country_code": "US",
"telephone_number": "855-337-6669",
"fax_number": "703-656-4777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NELSON DERMATOLOGY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-01",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "JENNELL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-373-9870",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Nelson Derm at Salon Lofts",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gainesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.