EVAN L NELSON JR. (NPI# 1306825294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306825294 |
| Entity Type | Individual |
| Full Name | EVAN L NELSON JR. |
| Credential | M.D. |
| Practice Address |
3517 Fairway Ridge Ln Sw Rochester MN 55902-2865 |
| Mailing Address |
200 1st St Sw Rochester MN 55905-0001 |
| Practice Telephone | 5079933987 |
| Mailing Telephone | 5072842511 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2008-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 15994 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | RAILROAD MEDICARE | 040002665 | 01 |
| IA | ENROLLED | 05 | |
| MN | 553382100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376861708 | Evan Paul Nelson | Dentist | 7 Summit St, Sisseton, SD 57262-2305 | 2010-05-10 |
| 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 |
| 1053375212 | Evan L Nelson | Family Medicine | 110 E Mescalero Rd, Roswell, NM 88201-6542 | 2006-04-14 |
| Street Address |
3517 FAIRWAY RIDGE LN SW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55902-2865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
| 1720584337 | John E Herman Home and Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 351 14th Ave Sw, Rochester, MN 55902 | 2018-04-03 |
| 1912442898 | Esperanza Torres | Dental Hygienist | 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 | 2016-12-30 |
| 1578971149 | Alduz Inri Surio Cabasa | Student in an Organized Health Care Education/Training Program | 609 1st Street Sw, Unit 102, Rochester, MN 55902 | 2014-07-28 |
| 1679901854 | Julie Erickson | Dental Hygienist | United Way Building Suite #208, Rochester, MN 55902 | 2013-10-24 |
| 1619313590 | Mercedes K Schulz | Dental Hygienist | 13394th Ave Sw, Rochester, MN 55902 | 2013-05-17 |
| 1093087389 | Sarah Jean Dennison | Clinic/Center | 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 | 2012-02-01 |
| 1467732156 | Angela Elizabeth Peters | Registered Nurse | 1450 2nd Avenue Sw, Rochester, MN 55902 | 2011-08-25 |
| 1528350071 | Emily Zahasky Kraft | Pharmacist | 204 1st Street Sw, Rochester, MN 55902 | 2011-05-03 |
| 1093021982 | Sherry Dawn Boutcher | Dental Hygienist | 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 | 2010-08-30 |
| Find all providers in zip 55902 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740697689 | Katherine Lees | Otolaryngology | 200 First St Nw, Rochester, MN 55905-0001 | 2014-07-11 |
| 1376960773 | Weitao Wang | Otolaryngology | 601 Elmwood Ave Box 629, Rochester, NY 14642-8629 | 2014-03-24 |
| 1851690283 | Alexis Mary Strohl-bryan | Otolaryngology | 2365 Clinton Ave S Ste 200, Rochester, NY 14618-2663 | 2011-03-24 |
| 1285959130 | Hitomi Sakano | Otolaryngology | 601 Elmwood Ave Rm 1-5039, Rochester, NY 14642 | 2010-04-05 |
| 1962644674 | Glenn Todd Schneider | Otolaryngology | 2365 South Clinton Avenue, Suite 200, Rochester, NY 14618-2663 | 2009-03-26 |
| 1164623633 | Tarek M Siala | Otolaryngology | 2365 South Clinton Ave, Suite 200, Rochester, NY 14618-2663 | 2007-05-30 |
| 1538375910 | Margo M Benoit | Otolaryngology | 2365 S. Clinton Ave, Ste 200, Rochester, NY 14618 | 2007-05-15 |
| 1275668956 | Harry Bryan Neel IIi | Otolaryngology | 828 8th St Sw, Rochester, MN 55902-6310 | 2007-02-22 |
| 1528024874 | Paul Topf | Otolaryngology | 1295 Portland Avenue, Suite 7, Rochester, NY 14621 | 2006-04-25 |
| 1639133044 | John Urban Coniglio | Otolaryngology | 1065 Senator Keating Boulevard, Suite 240, Rochester, NY 14618 | 2006-04-13 |
| Find all providers in ROCHESTER | ||||
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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.