Michael Nielson (NPI# 1700225679, PAC ID# 2264735455) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OSTEOPATHIC MANIPULATIVE MEDICINE.
| Nation Provider ID (NPI) | 1700225679 |
| PAC ID by PECOS | 2264735455 |
| Professional Enrollment ID | I20160622000080 |
| Full Name | Michael Nielson |
| Organization Legal Name | SAN JUAN COUNTY HOSPITAL |
| Address |
364 W 100 Monticello UT 84535-0308 |
| Phone Number | 4355872116 |
| Gender | M |
| Medical School | ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY |
| Graduation Year | 2013 |
| Primary Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| Group Practice PAC ID | 4486541851 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 461308 | SAN JUAN HOSPITAL |
| 061327 | SOUTHWEST MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 364 W 100, Monticello, UT 84535-0308 | 4355872116 | SAN JUAN COUNTY HOSPITAL |
| Organization Legal Name | SAN JUAN COUNTY HOSPITAL |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mario D La Giglia | General Surgery | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| James Walker | Physician Assistant | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Jane Sparks | Nurse Practitioner | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Kelly Marvin Jeppesen | Family Medicine | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Douglas Zeb Crofts | Family Medicine | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| Nicole M Fox | Physician Assistant | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Edwin M Wyman | Orthopedic Surgery | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Dashelle L Holliday | Nurse Practitioner | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| William Rainer | General Surgery | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Daniel Mower | Certified Registered Nurse Anesthetist | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| Street Address |
364 W 100 |
| City | MONTICELLO |
| State | UT |
| Zip | 84535-0308 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mario D La Giglia | General Surgery | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| Douglas Zeb Crofts | Family Medicine | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| Daniel Mower | Certified Registered Nurse Anesthetist | San Juan County Hospital | 364 W 100, Monticello, UT 84535-0308 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas Rhett Maughan | Chiropractic | 225 S Main, Monticello, UT 84535 | |
| William L Warner | Obstetrics/gynecology | Canyon View Medical Group LLC | 380 W 100, Monticello, UT 84535 |
| James Walker | Physician Assistant | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Jane Sparks | Nurse Practitioner | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Kelly Marvin Jeppesen | Family Medicine | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Nicole M Fox | Physician Assistant | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Edwin M Wyman | Orthopedic Surgery | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| Dashelle L Holliday | Nurse Practitioner | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| William Rainer | General Surgery | San Juan County Hospital | 380 W 100 N A, San Juan Clinic, Monticello, UT 84535-1054 |
| City | MONTICELLO |
| Zip Code | 84535 |
| Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| City + Specialty | MONTICELLO + OSTEOPATHIC MANIPULATIVE MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.