MR. NICHOLAS JEREMY NELSEN (NPI# 1437115326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437115326 |
| Entity Type | Individual |
| Full Name | MR. NICHOLAS JEREMY NELSEN |
| Credential | IDC |
| Practice Address |
1721 Admiral Taussig Blvd Norfolk VA 23511-2899 |
| Practice Telephone | 7574445511 |
| Mailing Telephone | 7574445511 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2009-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1721 ADMIRAL TAUSSIG BLVD |
| City | NORFOLK |
| State | VA |
| Zip Code | 23511-2899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588635072 | Alexander Royzenblat | Dentist | 1721 Admiral Taussig Blvd, Sewell's Point Branch Medical Clinic, Norfolk, VA 23511-2802 | 2006-02-01 |
| 1558877878 | Ismael Arturo Lopez | Military Health Care Provider | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2017-12-22 |
| 1184133670 | Jeffrey Joseph Illinik | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2017-09-27 |
| 1629525837 | Matthew Squires | Optometrist | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-09-06 |
| 1144775529 | Volha Zarubina Just | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-08-16 |
| 1891141768 | Itse Begho | Student in an Organized Health Care Education/Training Program | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-05-10 |
| 1134581176 | Damico Hill | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-03-28 |
| 1295194157 | David Barclay England II | Psychologist | 1721 Admiral Taussig Blvd, Department of Mental Health, Norfolk, VA 23511-2802 | 2016-02-19 |
| 1164808598 | Justin Michael Loder | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2015-08-07 |
| 1548645179 | Julie Simmons | Optometrist | 1721 Admiral Taussig Blvd, Optometry, Norfolk, VA 23511-2802 | 2015-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215591888 | Nash Richard Galvan | Military Health Care Provider | 456-462 Pocahontas St, Norfolk, VA 23511 | 2019-04-29 |
| 1578059481 | Hillary Anne Diffee | Dentist | Navsta Norfolk Sewells Point Branch Clinic, 1647 Admiral Taussig Blvd, Norfolk, VA 23511 | 2018-07-03 |
| 1154860237 | Alexander Blau | General Practice | 1751 Morris Street, Comnavsurflant - Medical Readiness Division, Norfolk, VA 23511 | 2017-02-22 |
| 1205188307 | Agnes Bautista Banias | Dental Hygienist | 1647 Admiral Taussig Blvd Br Health Clinic, Naval Medical Center Portsmouth, Norfolk, VA 23511 | 2012-10-12 |
| 1891052676 | Conor Francis Hynes | Surgery | 1530 Gilbert St Ste 2000, Norfolk, VA 23511 | 2012-04-18 |
| 1871867747 | Brian Joseph Kennerley | Surgery | U. S. Marine Corps Forces Command, 1775 Forrestal Drive Bldg 33, Norfolk, VA 23511 | 2012-02-23 |
| 1053629964 | Shawnly Heath Ward | Military Health Care Provider | Surface Warfare Medical Institute - East, 459 Bellinger Blvd, Norfolk, VA 23511 | 2010-09-14 |
| 1225351760 | Jocelyn Martinezdelgado | Military Health Care Provider | 8857 1st Street, Pcu Jason Dunham Suite 400, Norfolk, VA 23511 | 2010-03-11 |
| 1245480854 | Vanessa O Hofilena | Dentist | 1647 Admiral Taussig Boulevard, Naval Medical Center Portsmouth - Dental Center, Norfolk, VA 23511 | 2008-09-19 |
| 1780833954 | Cecilia M Brownblake | Dentist | 1647 Admiral Taussig Blvd., Norfolk, VA 23511 | 2008-09-12 |
| Find all providers in zip 23511 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447814090 | Francis Anthony Edquid | Military Health Care Provider | 9560 Farragut Ave, Norfolk, VA 23511-2715 | 2019-04-30 |
| 1215591888 | Nash Richard Galvan | Military Health Care Provider | 456-462 Pocahontas St, Norfolk, VA 23511 | 2019-04-29 |
| 1841694684 | Andre Huggins | Military Health Care Provider | 1687 Pocahontas St, Bldg 1a, Norfolk, VA 23511-2918 | 2014-10-21 |
| 1861753030 | Spencer Grey | Military Health Care Provider | 334 E Evans St, Norfolk, VA 23503-5213 | 2012-06-05 |
| 1508155375 | Leonard B Gordon | Military Health Care Provider | Comnavsurflant N02m, 1430 Mitscher Ave, Norfolk, VA 23551-2494 | 2011-04-01 |
| 1073812095 | Eric William Staley | Military Health Care Provider | 7958 Blandy Road, Commander Submarine Force Atlantic, Norfolk, VA 23551-2492 | 2011-03-16 |
| 1497051460 | Mitchell Todd Pearce | Military Health Care Provider | 1004 Hermitage Rd., Norfolk, VA 23521-5000 | 2011-02-08 |
| 1003119538 | Shayla R Robertson | Military Health Care Provider | 150 Allen St, Norfolk, VA 23505-1373 | 2010-12-05 |
| 1053629964 | Shawnly Heath Ward | Military Health Care Provider | Surface Warfare Medical Institute - East, 459 Bellinger Blvd, Norfolk, VA 23511 | 2010-09-14 |
| 1225351760 | Jocelyn Martinezdelgado | Military Health Care Provider | 8857 1st Street, Pcu Jason Dunham Suite 400, Norfolk, VA 23511 | 2010-03-11 |
| Find all providers in NORFOLK | ||||
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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.