DR. MATTHEW JAMES NELSON (NPI# 1760724132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760724132 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW JAMES NELSON |
| Credential | M.D. |
| Practice Address |
4100 Lake Dr Se Ste 205 Grand Rapids MI 49546-8292 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162677414 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301117478 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
4301117478 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801377767 | Matthew Ryan Nelson | Nurse Practitioner | 1974 N 540 E, Orem, UT 84097-2360 | 2018-08-28 |
| 1649783648 | Matthew Nelson | Occupational Therapy Assistant | 13915 North Mopac Expressway, Suite 200, Austin, TX 78728 | 2017-11-13 |
| 1861800898 | Matthew Nelson | Behavioral Analyst | 1972 Nortstar Way #163, San Marcos, CA 92078 | 2014-07-22 |
| 1396161154 | Matthew Nelson | Marriage & Family Therapist | 2100 County Road 42 W, Burnsville, MN 55337-6913 | 2014-03-17 |
| 1003245986 | Matthew Nelson | Specialist/Technologist | 1818 Belleville Rd Sw, Roanoke, VA 24015-2708 | 2013-11-01 |
| 1376986075 | Matthew Gene Nelson | Military Health Care Provider | 212 Wintergreen Ln, Hubert, NC 28539-4659 | 2013-04-11 |
| 1922310929 | Matthew Taylor Nelson | Anesthesiology | 6018 Wagon Mount Ct, Saint Louis, MO 63129-4043 | 2010-07-07 |
| 1518152875 | Matthew E Nelson | Dentist | 7101 E Thomas Rd, Scottsdale, AZ 85251-6336 | 2007-09-10 |
| 1518049295 | Matthew Nelson | Chiropractor | 3231 Rucker Ave, Everett, WA 98201-4224 | 2006-10-20 |
| 1164537155 | Matthew Michael Nelson | Dentist | 29992 Hunter Rd, Ste 110, Murrieta, CA 92563 | 2006-08-20 |
| Street Address |
4100 LAKE DR SE STE 205 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699001156 | Thomas Jay Beverwyk | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2009-10-19 |
| 1265073027 | Jared Thomas Courtright | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2019-10-03 |
| 1225596588 | Sheila Marie Zank | Nurse Practitioner | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2019-03-06 |
| 1417421405 | Margaret Elizabeth Peklo | Nurse Practitioner | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2019-01-14 |
| 1588031256 | Sarah Catherine Roy | Nurse Practitioner | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2015-08-28 |
| 1861890683 | Sandra Lynn Allen | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2014-12-10 |
| 1871995399 | Brittany Mara Dean | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2014-09-17 |
| 1104247410 | Ross Reynolds | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2014-01-05 |
| 1245598820 | Katherine A Kelley | Colon & Rectal Surgery | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2012-05-02 |
| 1821379132 | David Mark Ophoff | Physician Assistant | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2011-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003099904 | Gastroenterology Specialist PC | Internal Medicine | 1179 E Paris Ave Se Ste 200, Grand Rapids, MI 49546-3682 | 2007-12-13 |
| 1992801138 | Gastroenterology Institute of West Michigan PC | Internal Medicine | 1430 Michigan St Ne, Suite A, Grand Rapids, MI 49503-2006 | 2006-09-15 |
| 1033101977 | Digestive Diseases Specialists PC | Internal Medicine | 1200 East Paris Ave Se, Ste 8, Grand Rapids, MI 49546-8260 | 2005-08-17 |
| 1053620237 | Spectrum Health Primary Care Partners | Internal Medicine | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2010-10-05 |
| 1649581810 | Lindsay Smith Mohrhardt | Internal Medicine | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2010-06-23 |
| 1912227836 | Kamran Syed Kalim | Internal Medicine | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2010-06-02 |
| 1497070718 | Ryan Joshua Wong | Internal Medicine | 4100 Lake Dr Se Ste 205, Grand Rapids, MI 49546-8292 | 2010-03-30 |
| 1790915361 | Lia C Kaufman | Internal Medicine | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2009-07-17 |
| 1629218219 | Praveen Sateesh | Internal Medicine | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2009-02-23 |
| 1518119536 | Karen E Sein Ohn | Internal Medicine | 100 Cherry St Se, Grand Rapids, Grand Rapids, MI 49503-4526 | 2008-10-22 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.