KEVIN R NELSON (NPI# 1316379894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316379894 |
| Entity Type | Individual |
| Full Name | KEVIN R NELSON |
| Credential | PHARMD |
| Practice Address |
55 Pine Lake Ave La Porte IN 46350-3027 |
| Practice Telephone | 2193253152 |
| Mailing Telephone | 2193253152 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2020-01-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 26024735A | IN | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
26024735A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1154552958 | Kevin William Nelson | Occupational Therapist | 98 Forest Ave, West Caldwell, NJ 07006-7968 | 2009-07-29 |
| 1669601886 | Kevin Ted Nelson | Dentist | 5952 Blackstone Way Ste 100, Nine Mile Falls, WA 99026-4900 | 2009-07-09 |
| 1699978932 | Kevin Mann Nelson | Dentist | 350 W Woodrow Wilson Ave Ste 310, Jackson, MS 39213-7690 | 2007-06-06 |
| 1699824045 | Kevin Reed Nelson | Optometrist | 228 Bellows Avenue, Frankfort, MI 49635-2158 | 2007-01-08 |
| 1396810123 | Kevin T. Nelson | Dentist | 1116 W Loucks Ave, Peoria, IL 61604-2677 | 2006-11-20 |
| 1356440283 | Kevin Richard Nelson | Chiropractor | 309 N Labree, Thief River Falls, MN 56701-1912 | 2006-09-21 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1700857653 | Kevin D Nelson | Chiropractor | 9075 Forsstrom Dr, Lonetree, CO 80124-6737 | 2006-01-30 |
| 1922664705 | Kevin Jun Nelson | Physical Therapist | 3854 Village Seven Rd, Colorado Springs, CO 80917-2801 | 2019-05-16 |
| Street Address |
55 PINE LAKE AVE |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518506237 | Carrie Nicole Georgion | Pharmacist | 55 Pine Lake Ave, La Porte, IN 46350-3027 | 2019-12-28 |
| 1841837341 | Debra Wheeland | Pharmacist | 55 Pine Lake Ave, La Porte, IN 46350-3027 | 2019-12-03 |
| 1336786102 | Susan Jaracz | Pharmacist | 55 Pine Lake Ave, La Porte, IN 46350-3027 | 2019-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990204 | Jesus Ulises Anaya | Pharmacist | 1300 W Fairmont Pkwy, La Porte, TX 77571-6102 | 2020-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816766 | Kimberlee Chilcote | Pharmacist | 8275 Allison Pointe Trl Ste 370, Indianapolis, IN 46250-4298 | 2020-06-17 |
| 1700413721 | Damar Pharmacy Services LLC | Pharmacist | 5715 Decatur Blvd, Indianapolis, IN 46241-9561 | 2020-03-27 |
| 1871123562 | Kathy Jo Passereni | Pharmacist | 1541 Tipton St, Seymour, IN 47274 | 2020-01-22 |
| 1811537095 | Marla Ann Carroll | Pharmacist | 815 Highlander Point Drive, Floyds Knobs, IN 47119 | 2020-01-15 |
| 1508404815 | Shelli Ann Bulach | Pharmacist | 1034 Sr 229 North, Batesville, IN 47006 | 2019-12-17 |
| 1235773169 | Amy Epley | Pharmacist | 350 W Columbia St Ste 210, Evansville, IN 47710-1782 | 2019-11-04 |
| 1649767955 | Sean Meador | Pharmacist | 3630 31st Street, Columbus, IN 47203 | 2018-04-23 |
| 1093218489 | Sparkle Box | Pharmacist | 1908 Bluebird Ln, Munster, IN 46321-3429 | 2018-03-13 |
| 1194150490 | Janet Redmond | Pharmacist | 6911 Hillsdale Ct, Indianapolis, IN 46250-2054 | 2013-09-05 |
| 1962751446 | Robert L Plant | Pharmacist | 3602 New Vision Drive, Fort Wayne, IN 46845 | 2012-08-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KEVIN R NELSON.
| 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.