DR. CORY NELSON (NPI# 1417369588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417369588 |
| Entity Type | Individual |
| Full Name | DR. CORY NELSON |
| Credential | M.D. |
| Practice Address |
620 10th St N St Petersburg FL 33705-1407 |
| Mailing Address |
Po Box 12868 St Petersburg FL 33733-2868 |
| Practice Telephone | 7278243120 |
| Practice Fax Number | 7272848313 |
| Mailing Telephone | (727) 532-0002 |
| Mailing Fax Number | 7272664943 |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2017-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME125679 | FL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | TRN20293 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 021753400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326039843 | Cory Alan Nelson | Counselor | 1028 Walnut St, Lewis & Clark Bhs, Yankton, SD 57078-2910 | 2005-11-03 |
| 1962814954 | Cory Nelson | Pharmacist | 325 S Willis St, Visalia, CA 93291-6105 | 2014-05-23 |
| 1457771933 | Cory Nelson | Counselor | 835 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2014-04-23 |
| 1124339460 | Cory Nelson | Family Medicine | 3401 N Center St Ste 100, Lehi, UT 84043-7498 | 2010-07-01 |
| 1790945228 | Cory Oliver Nelson | Orthopaedic Surgery | 20401 N 73rd St, Suite 175, Scottsdale, AZ 85255-4107 | 2008-06-09 |
| 1295843886 | Cory J Nelson | Nurse Anesthetist, Certified Registered | 10 Kruger Rd, Plains, MT 59859-9506 | 2006-08-25 |
| Street Address |
620 10TH ST N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33705-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235124967 | James C. Mauch | Dermatology | 620 10th St N, St Petersburg, FL 33705-1407 | 2005-09-19 |
| 1639716764 | Rebecca Grimm | Nurse Practitioner | 620 10th St N, St Petersburg, FL 33705-1407 | 2019-12-09 |
| 1306211743 | Saint Petersburg Interventional Pain Management LLC | Pain Medicine | 620 10th St N, Suite 2d, St Petersburg, FL 33705-1407 | 2015-12-10 |
| 1992100788 | Tiffany Todd | Nurse Practitioner | 620 10th St N, St Petersburg, FL 33705-1407 | 2014-10-23 |
| 1457751687 | Warren S Gilbert | Physician Assistant | 620 10th St N, St Petersburg, FL 33705-1407 | 2014-08-25 |
| 1679997753 | Allison N Kyle | Nurse Practitioner | 620 10th St N, St Petersburg, FL 33705-1407 | 2014-02-11 |
| 1427488360 | Jessie Bardin Sereda | Nurse Practitioner | 620 10th St N, St Petersburg, FL 33705-1407 | 2013-11-13 |
| 1174960694 | Conrad Hernandez Vinalon Jr. | Family Medicine | 620 10th St N, St Petersburg, FL 33705-1407 | 2013-05-23 |
| 1174967129 | Monica Cristina Bovee | Specialist/Technologist | 620 10th St N, Suite 1d, St Petersburg, FL 33705-1407 | 2013-04-22 |
| 1740529270 | Anthony E Somai | Pharmacist | 620 10th St N, 101, St Petersburg, FL 33705 | 2013-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935781 | Caressa Alice Slocum | Psychologist | 840 Dr M.l.k. Jr St N, St. Petersburg, FL 33705 | 2020-09-01 |
| 1386133015 | Angela Ann Little | Social Worker | 920 Country Club Way S, St Petersburg, FL 33705 | 2018-05-08 |
| 1497279483 | Infinity Health Consultants, LLC. | In Home Supportive Care | 1001 27th Avenue South, St. Petersburg, FL 33705 | 2017-08-01 |
| 1801320528 | Dedicated Senior Medical Center St. Petersburg, LLC. | Non-Pharmacy Dispensing Site | 901 22nd Avenue South, Dedicated Senior Medical Center St. Petersburg, LLC., St. Petersburg, FL 33705 | 2017-04-19 |
| 1790135762 | Robin Dong | Emergency Medicine | 1095 5th Ave N, St. Petersburg, FL 33705 | 2016-06-20 |
| 1437550084 | Community Health Center of Pinellas Inc | Clinic/Center | 612 Dr Martin L King St N, St Petersburg, FL 33705 | 2014-09-12 |
| 1164851754 | Jennifer Carey | Counselor | 11 Mlk Jr St South, St. Petersburg, FL 33705 | 2013-11-05 |
| 1750623997 | Dannaly Reyes Baerga | Physical Medicine & Rehabilitation | 1201 5th Ave N Ste 202, St Petersburg, FL 33705 | 2013-03-26 |
| 1518209055 | Nii Sai Torto | Emergency Medicine | 500 Doctor. M.l.k, Jr. Street North, Ste 303, Saint Petersburg, FL 33705 | 2013-03-22 |
| 1790034635 | Melissa White Kidwell | Physical Therapist | 500 Mlking Street N, Ste 100, St. Petersburg, FL 33705 | 2012-09-06 |
| Find all providers in zip 33705 | ||||
| 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 |
|---|---|---|---|---|
| 1053919951 | Rhc St Pete LLC | Family Medicine | 5999 Central Ave Ste 103, St Petersburg, FL 33710-8535 | 2020-10-13 |
| 1306452875 | Ohi West, Inc | Family Medicine | 700 6th St S Fl 3, St Petersburg, FL 33701-4815 | 2020-09-21 |
| 1609489541 | Binsey C Babu | Family Medicine | 8950 Dr Martin Luther King Jr St N Ste 102, St Petersburg, FL 33702-3001 | 2020-08-29 |
| 1588174585 | Elena Borisenko | Family Medicine | 5778 5th Ave N, St Petersburg, FL 33710-7104 | 2017-10-04 |
| 1336667187 | Amar Talati, Do, LLC | Family Medicine | 2901 1st Ave N Ste 301, St Petersburg, FL 33713-8640 | 2017-08-31 |
| 1265954085 | St. Petersburg Primary Care Associates | Family Medicine | 780 4th Ave S, St Petersburg, FL 33701-4412 | 2017-07-13 |
| 1659818102 | Diligent Care LLC | Family Medicine | 6743 14th Ave N, St Petersburg, FL 33710-5405 | 2017-01-23 |
| 1821476458 | Chantel Tenesia Jacobs | Family Medicine | 7751 9th St N, St Petersburg, FL 33702-1102 | 2015-05-15 |
| 1003228131 | Carolina Vac Nelson | Family Medicine | 7751 9th St N Ste 10, St Petersburg, FL 33702-1102 | 2014-05-23 |
| 1700205069 | Carol Thuy Vy Tran | Family Medicine | 6801 4th St N, St Petersburg, FL 33702 | 2014-04-15 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33705 |
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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.