EVAN L NELSON (NPI# 1053375212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053375212 |
| Entity Type | Individual |
| Full Name | EVAN L NELSON |
| Credential | MD |
| Practice Address |
110 E Mescalero Rd Roswell NM 88201-6542 |
| Mailing Address |
1112 N Main St Roswell NM 88201-5010 |
| Practice Telephone | 5757552272 |
| Practice Fax Number | 5756223325 |
| Mailing Telephone | 5756274200 |
| Mailing Fax Number | 5756274212 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 87-381 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 34684565 | 05 | |
| NM | MEDICARE PTAN | 330095YM5A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1112 N Main St, Roswell, NM 882015010 | 5756274200 | 5756274212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376861708 | Evan Paul Nelson | Dentist | 7 Summit St, Sisseton, SD 57262-2305 | 2010-05-10 |
| 1306825294 | Evan L Nelson Jr. | Otolaryngology | 3517 Fairway Ridge Ln Sw, Rochester, MN 55902-2865 | 2006-01-10 |
| 1154323467 | Evan R Nelson | Physical Medicine & Rehabilitation | 800 West Ave S, La Crosse, WI 54601 | 2005-06-01 |
| 1396092359 | Evan C. Nelson | Physician Assistant | 1518 Mulberry Ave, Muscatine, IA 52761-3433 | 2012-08-09 |
| 1053585539 | Evan Nelson | Internal Medicine | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2008-04-16 |
| 1780884056 | Evan Nelson | Physical Therapist | 6908 N Santa Monica Blvd, Fox Point, WI 53217-3942 | 2007-07-24 |
| Street Address |
110 E MESCALERO RD |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-6542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417938952 | Mary Sue Blackhurst | Counselor | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2005-11-10 |
| 1154939502 | Madison Holm | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2020-07-21 |
| 1346884517 | Marisa Juarez | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-10-31 |
| 1346897634 | Erin Jeanette Montgomery | Marriage & Family Therapist | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-08-21 |
| 1255985693 | Misty Renee Sturtevant | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-07-24 |
| 1205488715 | Sara Michelle Rodriguez | Counselor | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-07-15 |
| 1801355672 | Camille Berrones | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2019-03-19 |
| 1346721933 | Rebeca Vazquez | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-08-22 |
| 1104315985 | Johnny Ray Ibarra | Social Worker | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-05-07 |
| 1528565959 | Jazmin E Sarabia | Case Manager/Care Coordinator | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2018-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114543196 | Injury Md LLC | Family Medicine | 245 Steeple Point Dr, Roswell, GA 30076-5521 | 2020-06-24 |
| 1073070991 | Hip Medical Georgia,llc | Family Medicine | 11660 Alpharetta Hwy Ste 285, Roswell, GA 30076-3876 | 2019-02-27 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1801261714 | Arnett Medical, LLC | Family Medicine | 1915 N Atkinson Ave, Roswell, NM 88201-7600 | 2015-12-02 |
| 1265792022 | Brandon C Cometti | Family Medicine | 300 W Country Club Rd Ste 210, Roswell, NM 88201-5240 | 2012-05-25 |
| 1790095974 | Lawrence Joseph Barbour Sr. | Family Medicine | 803 Sherrill Ln, Roswell, NM 88201-3469 | 2010-10-20 |
| 1699099390 | New Mexico Medical Surgical Hospital LLC | Family Medicine | 2335 N Main St, Roswell, NM 88201-6452 | 2010-03-24 |
| 1700016284 | Jeremy D Boyd | Family Medicine | 9420 Willeo Rd Ste 206, Roswell, GA 30075-6773 | 2009-07-20 |
| 1497990220 | David Ludvig Hammer | Family Medicine | 10535 Turner Rd, Roswell, GA 30076-2438 | 2008-12-08 |
| 1578728309 | Lakshmi Gopireddy | Family Medicine | 3000 Hospital Blvd Fl 2, Roswell, GA 30076 | 2008-07-21 |
| Find all providers in ROSWELL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.