DEREK E NEILSON (NPI# 1548293822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548293822 |
| Entity Type | Individual |
| Full Name | DEREK E NEILSON |
| Credential | MD |
| Practice Address |
1920 E Cambridge Ave Ste 304 Phoenix AZ 85006 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2327 |
| Practice Telephone | 6029334363 |
| Practice Fax Number | 6029332415 |
| Mailing Telephone | 6029331814 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2018-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
56355 | AZ | Allopathic & Osteopathic Physicians |
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
35-083650 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | UNISON | 000000224312 | 01 |
| OH | WELLCARE | 363878 | 01 |
| OH | ANTHEM | 000000529594 | 01 |
| OH | 2499952 | 05 | |
| OH | AETNA | 7841606 | 01 |
| OH | ANTHEM | 000000340115 | 01 |
| OH | BUCKEYE | 745996 | 01 |
| Street Address |
1920 E CAMBRIDGE AVE STE 304 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861453490 | Gena R Wilson | Nurse Practitioner | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006 | 2006-03-31 |
| 1841818382 | Allison Mary Abbott | Genetic Counselor, MS | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006-1464 | 2020-07-10 |
| 1306023593 | Kristin E Lindstrom | Medical Genetics | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006-1464 | 2008-01-30 |
| 1659459444 | John C. Baker | Medical Genetics | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
| 1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
| 1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
| 1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
| 1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
| Find all providers in zip 85006 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164839429 | Christine Hope Umandap | Medical Genetics | 3141 N 3rd Ave, Phoenix, AZ 85013-4360 | 2014-07-18 |
| 1932471323 | John C. Lincoln Genetics Cancer Risk | Medical Genetics | 19646 N 27th Ave, Ste. 201, Phoenix, AZ 85027-4017 | 2012-02-01 |
| 1073791992 | Jacqueline Siegel-bartelt | Medical Genetics | 124 W Thomas Rd, Phoenix, AZ 85013-4405 | 2008-02-01 |
| 1306023593 | Kristin E Lindstrom | Medical Genetics | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006-1464 | 2008-01-30 |
| 1659459444 | John C. Baker | Medical Genetics | 1920 E Cambridge Ave Ste 304, Phoenix, AZ 85006 | 2006-11-01 |
| 1346202991 | Theresa A Grebe | Medical Genetics | 1919 E Thomas Rd, East Building, Phoenix, AZ 85016-7710 | 2006-04-06 |
| 1891767307 | Kyrieckos A Aleck | Medical Genetics | 1919 E Thomas Rd, East Building, Phoenix, AZ 85016-7710 | 2006-02-07 |
| 1982674123 | Philip M James | Medical Genetics | 1920 E Cambridge Ave, Ste 304, Phoenix, AZ 85006-1459 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518077908 | Harold Eugene Hoyme | Medical Genetics | 1501 N Campbell Ave, Tucson, AZ 85724-0001 | 2006-08-30 |
| 1396775482 | Margaret A Pearson | Medical Genetics | 10900 N Scottsdale Rd, 206, Scottsdale, AZ 85254-5216 | 2006-07-04 |
| 1235108002 | Gary F Simpson | Medical Genetics | 6301 S Mcclintock Dr, Suite 115, Tempe, AZ 85283-3392 | 2006-03-15 |
| 1609845619 | Arizona Institute for Genetics and Fetal Medicine, A Professional Corp | Medical Genetics | 6301 S Mcclintock Dr, Suite 115, Tempe, AZ 85283-3392 | 2006-03-14 |
Please comment or provide details below to improve the information on DEREK E NEILSON.
| 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.