JONATHAN D NELSON (NPI# 1265882070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265882070 |
| Entity Type | Individual |
| Full Name | JONATHAN D NELSON |
| Credential | PA-C |
| Practice Address |
555 W Sr 164 Salem UT 84653 |
| Mailing Address |
1055 N 500 W Attn: Credentialing Provo UT 84604-3305 |
| Practice Telephone | 8014654813 |
| Practice Fax Number | 8018125433 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014180941 |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2020-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10406360-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 3752-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1055 N 500 W Ste 212, Provo, UT 846043305 | 8014654813 | 8018125433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003112269 | Jonathan Nelson | Registered Nurse | 704 Sara Cir, Marshall, MN 56258-2132 | 2011-02-07 |
| 1497982151 | Jonathan Scott Nelson | Counselor | 129 Phelps Ave Ste 204, Rockford, IL 61108-2447 | 2009-06-19 |
| 1306408885 | Jonathan Ray Nelson | Physical Therapy Assistant | 1401 E State St, Rockford, IL 61104-2315 | 2019-07-03 |
| 1629550744 | Jonathan Richard Nelson IIi | Counselor | 900 N Swallow Tail Dr Ste 105, Port Orange, FL 32129-6103 | 2018-09-05 |
| 1205340981 | Jonathan Michael Nelson | Registered Nurse | 3873 N Parkview Dr, Fayetteville, AR 72703-6286 | 2017-11-17 |
| 1043633407 | Jonathan V Nelson | Counselor | 233 Gooding St N, Twin Falls, ID 83301-6179 | 2014-01-21 |
| 1801237920 | Jonathan Eugene Nelson | Dentist | 3700 S Russell St, Ste. #116, Missoula, MT 59801-8574 | 2013-07-17 |
| 1942561329 | Jonathan Paul Nelson | Acupuncturist | 2831 Telegraph Ave, Oakland, CA 94609-3649 | 2012-06-02 |
| 1285991851 | Jonathan Scott Nelson | Urology | Msc 10 5610, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2012-04-19 |
| 1194933812 | Jonathan Campbell Nelson | Surgery | 2727 W Holcombe Blvd, Houston, TX 77025-1669 | 2007-05-18 |
| Street Address |
555 W SR 164 |
| City | SALEM |
| State | UT |
| Zip Code | 84653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104875574 | Tala'at Al-shuqairat | Internal Medicine | 555 W Sr 164, Salem, UT 84653-1666 | 2006-05-10 |
| 1598235798 | Jonathan Rudy Brown | Physician Assistant | 555 W Sr 164, Salem, UT 84653 | 2018-11-29 |
| 1417430497 | Whitney Mccoy | Physician Assistant | 555 W Sr 164, Salem, UT 84653 | 2018-09-14 |
| 1467955526 | Tye Frank Johnson | Physician Assistant | 555 W Sr 164, Salem, UT 84653 | 2018-03-15 |
| 1861912693 | Sarah Larsen | Physical Therapist | 555 W Sr 164, Salem, UT 84653 | 2017-06-22 |
| 1528426988 | Alex S Moore | Physical Therapist | 555 W Sr 164, Salem, UT 84653 | 2016-02-01 |
| 1205224276 | Shawn Stephen Hill | Physician Assistant | 555 W Sr 164, Salem, UT 84653-1635 | 2014-12-29 |
| 1528461019 | Lindsey Kenz Seaver | Physician Assistant | 555 W Sr 164, Salem, UT 84653-1635 | 2014-09-29 |
| 1073930020 | Seth James Coynor | Pediatrics | 555 W Sr 164, Salem, UT 84653 | 2014-03-27 |
| 1689003550 | Central Utah Clinic, P.C. | Clinic/Center | 555 W Sr 164, Salem, UT 84653 | 2013-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1811357791 | Melanie Pace | Dental Hygienist | 818 East 750 South, Salem, UT 84653 | 2016-03-04 |
| 1265773899 | Bill Clifford Marshall | Marriage & Family Therapist | 405 S Maple Dr, Woodland Hills, UT 84653 | 2013-03-06 |
| 1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
| 1780884247 | David Kent Hansen | Dentist | 204 East 400 North, Suite A, Salem, UT 84653 | 2007-07-23 |
| 1154524965 | Justin Thomas Perry | Dentist | 40 South 200 West, Salem, UT 84653 | 2007-06-08 |
| 1013130947 | John E Braithwaite | Dentist | 40 S 200 W, Salem, UT 84653 | 2007-04-10 |
| 1104972827 | Salem City Corporation | Ambulance | 30 W 100 S, Salem, UT 84653 | 2007-01-26 |
| 1700989209 | James Bryan Bonny | Dentist | 245 W State Hwy 198, Suite 6, Salem, UT 84653 | 2006-09-07 |
| 1578574570 | Kids Who Count | Day Training, Developmentally Disabled Services | 345 N Sr 198, Salem, UT 84653 | 2006-08-11 |
| Find all providers in zip 84653 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374660 | Sarah Ilana Katz | Physician Assistant | 11a Laurel St, Salem, MA 01970-4657 | 2020-10-21 |
| 1306444641 | Zachary Wright | Physician Assistant | 11 Harley Ln, Salem, NH 03079-2888 | 2020-10-09 |
| 1174132195 | Andrew Yosim | Physician Assistant | 1750 Pexton Ave, Salem, VA 24153-4108 | 2020-07-27 |
| 1689202269 | Adam Joyce | Physician Assistant | 1005 Meadowrun Ct, Salem, VA 24153-6687 | 2020-03-30 |
| 1417504085 | Alexis Marie Biewend | Physician Assistant | 1645 Waln Dr Se Apt 263, Salem, OR 97306-2963 | 2019-08-19 |
| 1497309322 | Lindsey Ann Castleberry | Physician Assistant | 1111 Meadow Sage Cir, Salem, UT 84653-5578 | 2019-07-29 |
| 1134773450 | Jillian Netland | Physician Assistant | 6507 Lipscomb St Se, Salem, OR 97317-9513 | 2019-07-25 |
| 1457827354 | Gretchen Amrien | Physician Assistant | 4 Bypass Rd Ste 201, Salem, NJ 08079-2053 | 2018-10-17 |
| 1649751934 | Matthew Hansen | Physician Assistant | 875 Oak St. Se Ste 5020, Salem, OR 97301 | 2018-08-24 |
| 1487152948 | Jessica Lynn Brooks | Physician Assistant | 875 Oak St Se Ste 5060, Salem, OR 97301 | 2018-01-30 |
| Find all providers in SALEM | ||||
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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.