MR. DEREK M NELSON (NPI# 1659325033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659325033 |
| Entity Type | Individual |
| Full Name | MR. DEREK M NELSON |
| Credential | PA-C |
| Practice Address |
810 N 22nd St Blair NE 68008-1128 |
| Practice Telephone | 4024262182 |
| Practice Fax Number | 4024261190 |
| Mailing Telephone | 4024262182 |
| Mailing Fax Number | 4024261190 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1126 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025355300 | 05 | |
| NE | 10025300500 | 05 | |
| CAQH | 12350231 | 01 | |
| NE | BLUE CROSS | 30694 | 01 |
| NE | DEA NUMBER | MN1082990 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 306 W 2nd St, Tilden, NE 687814760 | 4023689964 | 4023685675 |
| 810 N 22nd St, Blair, NE 680081128 | 4024261150 | 4024261190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902070659 | Derek Julius Nelson | Chiropractor | 5734 Sheridan Lake Road, Suite 201, Rapid City, SD 57702 | 2008-04-14 |
| 1083196950 | Derek Nelson | Counselor | 9700 S Pennsylvania Ave, Oklahoma City, OK 73159-6917 | 2018-09-06 |
| 1124487640 | Derek Dee Nelson | Chiropractor | 3625 Western Center Blvd, Fort Worth, TX 76137-1936 | 2016-02-11 |
| 1821370685 | Derek Nelson | Physician Assistant | 1055 Saxon Blvd, Orange City, FL 32763-8468 | 2011-09-16 |
| 1275854242 | Derek James Nelson | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2010-06-14 |
| Street Address |
810 N 22ND ST |
| City | BLAIR |
| State | NE |
| Zip Code | 68008-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649278334 | John Steigner | Emergency Medicine | 810 N 22nd St, Memorial Community Hospital Corporation, Blair, NE 68008-1128 | 2005-07-07 |
| 1093354888 | Mitzi Klimek | Dietitian, Registered | 810 N 22nd St, Blair, NE 68008-1128 | 2019-12-27 |
| 1972026995 | Susann Ashley O'banion | Nurse Practitioner | 810 N 22nd St, Blair, NE 68008-1128 | 2017-07-21 |
| 1629506100 | Jordan Stilmock | Dietitian, Registered | 810 N 22nd St, Blair, NE 68008-1128 | 2017-05-30 |
| 1841694106 | Katherine Orr | Physical Therapist | 810 N 22nd St, Blair, NE 68008-1128 | 2014-10-15 |
| 1730427451 | Kyle Gerard Suing | Physical Therapist | 810 N 22nd St, Blair, NE 68008-1128 | 2013-01-30 |
| 1922373141 | Catherine A White | Physical Therapist | 810 N 22nd St, Blair, NE 68008-1128 | 2012-03-21 |
| 1154698066 | Janice C Fitchhorn | Occupational Therapist | 810 N 22nd St, Blair, NE 68008-1128 | 2011-11-20 |
| 1922304682 | Foot and Ankle Clinic, PC | Podiatrist | 810 N 22nd St, Blair, NE 68008-1128 | 2011-01-28 |
| 1497994230 | Jeremy Lee | Emergency Medicine | 810 N 22nd St, Blair, NE 68008-1128 | 2009-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747080 | Mark Allen Kwikkel | Specialist/Technologist | 310 N 10th, Blair, NE 68008 | 2020-07-17 |
| 1750752432 | Mindy Logston | Speech-Language Pathologist | 1717 Adams Street, Blair, NE 68008 | 2015-10-07 |
| 1952545709 | Home Care Network, Inc | Nursing Care | 14700 State Highway 133, Blair, NE 68008 | 2009-04-23 |
| 1619114246 | Andrea L Ott | Physician Assistant | 812 N 22nd Street, Blair Clinic, Blair, NE 68008 | 2009-01-20 |
| 1730376047 | Assisted Living Concepts Inc | Assisted Living Facility | 1028 Joann Drive, Blair, NE 68008 | 2007-10-01 |
| 1497956478 | Charles Leroy Gleeson | Pharmacist | 9889 Cr 29, Blair, NE 68008 | 2007-05-29 |
| 1144322082 | Richard K Ward | Emergency Medicine | 810 N. 22nd Street, Mch & Health System, Blair, NE 68008 | 2006-09-01 |
| 1942319116 | Lisa A. Babcock | Audiologist | 11223 N. Lakeshore Dr., Blair, NE 68008 | 2006-08-30 |
| 1841637139 | Paula J. Thielen-kocharov | Family Medicine | 812 N 22nd St, Blair, NE 68008 | 2013-05-28 |
| 1588849848 | Vision Care Clinic PC | Optometrist | 1526 Washington St, Blair, NE 68008 | 2008-01-07 |
| Find all providers in zip 68008 | ||||
| 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 |
|---|---|---|---|---|
| 1619114246 | Andrea L Ott | Physician Assistant | 812 N 22nd Street, Blair Clinic, Blair, NE 68008 | 2009-01-20 |
| 1184779241 | Susan Ryan | Physician Assistant | 718 S 19th St, Blair, NE 68008-1887 | 2007-01-25 |
| 1780161109 | Elizabeth Otte | Physician Assistant | 812 N 22nd St, Blair, NE 68008-1128 | 2018-07-27 |
| 1942361845 | Suzanne M Nass | Physician Assistant | 407 S 19th St, Blair, NE 68008-1907 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184434 | Jacob Solomon Morrill | Physician Assistant | 2701 W Norfolk Ave Fl 4, Norfolk, NE 68701-4407 | 2020-11-07 |
| 1609475375 | Patrick Donald Heavey | Physician Assistant | 4660 Pine St, Omaha, NE 68106-2520 | 2020-10-22 |
| 1780297440 | Tayler Marie Llewellyn | Physician Assistant | 17241 Oak Dr, Omaha, NE 68130-2428 | 2020-08-24 |
| 1154933992 | Alexandria Rae Mctaggart | Physician Assistant | 5024 S 130th St, Omaha, NE 68137-1820 | 2020-08-22 |
| 1477170082 | Audrey Caroline Smith | Physician Assistant | 1303 N 188th St, Elkhorn, NE 68022-4501 | 2020-06-30 |
| 1851917181 | Connor Evan Bliss | Physician Assistant | 2908 W 39th St Ste D, Kearney, NE 68845-1245 | 2020-06-23 |
| 1124651443 | Kathryn A Kesti | Physician Assistant | 4242 Farnam St Ste 500, Omaha, NE 68131-2850 | 2020-02-14 |
| 1760014757 | Timothy Shew | Physician Assistant | 7500 Mercy Rd Ste 1300, Omaha, NE 68124-2319 | 2020-02-07 |
| 1659901601 | Jordan Marie Morris | Physician Assistant | 821 Bordeaux St, Chadron, NE 69337-2614 | 2020-01-17 |
| 1083264303 | Alicia K Clough | Physician Assistant | 15236 Westchester Dr, Omaha, NE 68154-2060 | 2019-09-18 |
| Find all providers with the same taxonomy | ||||
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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.