DR. GARY REX NELSON (NPI# 1841515517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841515517 |
| Entity Type | Individual |
| Full Name | DR. GARY REX NELSON |
| Credential | M.D. |
| Practice Address |
100 Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Mailing Address |
127 S 500 E Salt Lake City UT 84102-1959 |
| Practice Telephone | 8016621000 |
| Mailing Telephone | 8015876336 |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2015-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 8134458-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
8134458-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083088868 | Gary Nelson | Counselor | 8008 Route 130 Bldg A, Ste 206, Delran, NJ 08075-1869 | 2015-11-17 |
| 1255536454 | Gary Nelson | Counselor | Rr 3 Box 1230, Wilburton, OK 74578-9523 | 2007-06-18 |
| 1619090834 | Gary L Nelson | Counselor | 14301 County Highway B, Sparta, WI 54656-4509 | 2007-04-10 |
| 1558423384 | Gary Lee Nelson | Dentist | 274 Delaware Avenue, Delmar, NY 12054 | 2006-12-15 |
| 1033277629 | Gary H Nelson | Technician/Technologist | 707 Fairmount Ave, Suite 11, Jamestown, NY 14701-2623 | 2006-12-05 |
| 1700954518 | Gary J Nelson | Dentist | 3350 S 15th E, Idaho Falls, ID 83404-8321 | 2006-12-01 |
| 1144327396 | Gary G Nelson | Specialist/Technologist | 2580 Mccrays Mill Rd, Sumter, SC 29154-6028 | 2006-09-20 |
| 1629035795 | Gary E Nelson | Physician Assistant | 150 E Center St, Suite 1100, Provo, UT 84606-3106 | 2006-05-01 |
| 1245209634 | Gary Robert Nelson | Family Medicine | 3320 N Benzing Rd, Orchard Park, NY 14127-1538 | 2006-03-16 |
| 1396290201 | Gary Edwin Nelson | Pharmacist | 1700 Ne 102nd Ave, Portland, OR 97220-3804 | 2016-08-20 |
| Street Address |
100 MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
| 1235535485 | Ihc Health Services Inc | Clinic/Center | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-17 |
| 1508262833 | Aimee Brierley | Occupational Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-13 |
| 1801290986 | Jeffery Zobell | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-10-17 |
| 1336542778 | Bevan Jensen | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-09-30 |
| 1699183152 | Kristina Rogers | Dentist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-07-29 |
| 1548677297 | Stephanie Eva Wisniewski | Speech-Language Pathologist | 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 | 2014-07-15 |
| 1184044877 | Adam Wesley Dell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-04-21 |
| 1225456718 | Bhanu Muniyappa | Pediatrics | 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 | 2014-04-01 |
| 1265850952 | Kristina Gulliver | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770032427 | Felippe Borlot | Psychiatry & Neurology | 175 N Medical Dr E, Salt Lake City, UT 84132-0001 | 2016-09-22 |
| 1912387598 | Audie Christopher Espinoza | Psychiatry & Neurology | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2015-06-09 |
| 1255698726 | Carey A. Wilson | Psychiatry & Neurology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113 | 2012-04-20 |
| 1679739395 | Betsy Ostrander | Psychiatry & Neurology | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2008-08-01 |
| 1639352321 | Russell James Butterfield | Psychiatry & Neurology | 50 N Medical Dr, Salt Lake City, UT 84112-1103 | 2007-12-17 |
| 1477755155 | Jeffrey John Ekstrand | Psychiatry & Neurology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-06-04 |
| 1902959323 | Ai Sakonju | Psychiatry & Neurology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-01-19 |
| 1740369214 | Susan Lee Benedict | Psychiatry & Neurology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2006-11-03 |
| 1841233749 | Christopher Jones | Psychiatry & Neurology | 375 Chipeta Way, Suite 200a, Salt Lake City, UT 84108-1260 | 2006-06-14 |
| 1083611966 | Western Neurological Associates Inc | Psychiatry & Neurology | 1151 E 3900 S, #b150, Salt Lake City, UT 84124-1216 | 2005-07-07 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
Please comment or provide details below to improve the information on DR. GARY REX 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.