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MR. CHRISTOPHER L. NELSON PA NPI 1114911971


NPI Information

NPI: 1114911971
Provider Name: MR. CHRISTOPHER L. NELSON, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: CARLE WEST PHYSICIAN GROUP INC

PECOS Registration: Yes

Address:
1302 FRANKLIN AVE STE 4500
NORMAL, IL
ZIP 61761
Phone: (309) 556-8300
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MR. Christopher L. Nelson, PA is a surgical physician assistant in Normal, IL with 34 years of experience. MR. Christopher L. Nelson, PA NPI is 1114911971. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduation Year:1990

The provider's business location address is:

1302 FRANKLIN AVE STE 4500
NORMAL, IL
ZIP 61761-593
Phone: (309) 556-8300
Fax: (309) 556-8293

The NPI 1114911971 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Heart artery bypass to repair one artery (HCPCS:33533)
  • Harvest of veins for coronary artery bypass procedure using an endoscope (HCPCS:33508)

The enumeration date for this NPI number is 9/8/2005 and was last updated on 1/6/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular Disease085000452ILLINOISNo
2363AS0400XPhysician AssistantSurgical085000452ILLINOISYes
3363AS0400XPhysician AssistantSurgical2974TENNESSEENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Q020561MEDICAIDTENNESSEE
27100424840MEDICAIDTENNESSEE
36076339/6066808OTHERTENNESSEEBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.