MR. BRADLEY ROBERT NELSON (NPI# 1902822919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902822919 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY ROBERT NELSON |
| Credential | MALP |
| Practice Address |
423 Ne 4th St Grand Rapids MN 55744 |
| Mailing Address |
Po Box 534 Grand Rapids MN 55744 |
| Practice Telephone | 2183260783 |
| Practice Fax Number | 2183276928 |
| Mailing Telephone | 2183260783 |
| Mailing Fax Number | 2183276928 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP0590 | MN | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 4K585NE | 01 |
| MN | MEDICA | 6275968 | 01 |
| MN | PREFERRED ONE | 3032501 | 01 |
| MN | HEALTH PARTNERS | 97026 | 01 |
| MN | UCARE | 160767 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093027799 | Bradley Clark Nelson | Internal Medicine | 9500 Gilman Drive, Mail Code 7411, University of California San Diego Health System, La Jolla, CA 92037 | 2010-07-09 |
| 1447399803 | Bradley Jerome Nelson | Dentist | 860 E Sahara Ave, #2, Las Vegas, NV 89104-3032 | 2007-02-05 |
| 1154330918 | Bradley J. Nelson | Dentist | 363 5th Ave N, Bayport, MN 55003-1232 | 2006-08-07 |
| 1619950839 | Bradley James Nelson | Orthopaedic Surgery | 2512 S 7th St, Department of Orthopaedics, R200, Minneapolis, MN 55454-1404 | 2005-11-22 |
| 1285634469 | Bradley D Nelson | Podiatrist | 207 S 30th Street, Clinton, OK 73601 | 2005-07-28 |
| 1457951543 | Bradley John Nelson | Pharmacist | 500 Crossroads Dr Sw, Rochester, MN 55902-2180 | 2020-10-28 |
| 1154952554 | Bradley Nelson | Behavior Technician | 2925 Dean Pkwy Ste 300, Minneapolis, MN 55416-7700 | 2020-02-04 |
| 1487004925 | Bradley G Nelson | Dentist | 5215 W Village Pkwy, Rogers, AR 72758-8104 | 2016-06-15 |
| 1083008924 | Bradley Eugene Nelson | Registered Nurse | 622 W 168th St, New York, NY 10032-3720 | 2015-03-27 |
| 1497175277 | Bradley Nelson | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Orthopedic Surgery, Albany, NY 12208-3412 | 2014-04-21 |
| Street Address |
423 NE 4TH ST |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659377703 | Jay Sonder | Chiropractor | 423 Ne 4th St, Ste 1, Grand Rapids, MN 55744-2968 | 2005-06-23 |
| 1730631961 | Grant Ferguson | Chiropractor | 423 Ne 4th St, 1, Grand Rapids, MN 55744-2968 | 2016-11-04 |
| 1437522711 | Lisa Riggs Aprn Cnp LLC | Nurse Practitioner | 423 Ne 4th St, Suite 6, Grand Rapids, MN 55744-2968 | 2015-11-09 |
| 1225097736 | Sonder Chiropractic, P.a. | Chiropractor | 423 Ne 4th St, Suite 1, Grand Rapids, MN 55744-2968 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205490240 | Maxwell Taylor | Psychologist | 401 Hall St Sw Ste 112b, Grand Rapids, MI 49503-4988 | 2019-04-25 |
| 1760995146 | Stephanie Elizabeth Karek | Psychologist | 4467 Cascade Rd Se Ste A4469, Grand Rapids, MI 49546-3791 | 2017-11-08 |
| 1114447745 | Andrea Gumbko | Psychologist | 3403 Michigan St Ne, Grand Rapids, MI 49525-3408 | 2017-06-24 |
| 1720529332 | Clearwater Counseling & Wellness LLC | Psychologist | 1525 E Beltline Se, Grand Rapids, MI 49525-4598 | 2017-03-15 |
| 1851748768 | Heather Dermyer, LLC | Psychologist | 3330 Centennial Rdg, #205, Grand Rapids, MI 49546-7098 | 2016-05-20 |
| 1902265234 | Lauren Conkright | Psychologist | 1009 44th St Se, Suite 103, Grand Rapids, MI 49508 | 2016-02-15 |
| 1225409220 | Christian Robert Komor | Psychologist | 235 Louis St Nw, Grand Rapids, MI 49503-2600 | 2015-10-15 |
| 1780022194 | Gregory V Mallis | Psychologist | 1870 Leonard St Se, Grand Rapids, MI 49505-5650 | 2013-06-07 |
| 1821344136 | Laura Ann Doughty | Psychologist | 800 Monroe Ave Nw Ste 206, Grand Rapids, MI 49503-1448 | 2012-07-24 |
| 1528321296 | Mikhila N Wildey | Psychologist | 300 58th St Se, Grand Rapids, MI 49548-5984 | 2012-06-19 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on MR. BRADLEY ROBERT 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.