Provider Demographics
NPI:1366448649
Name:NELSON, SCOTT C (DPM)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:NELSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16909 LAKESIDE HILLS CT
Mailing Address - Street 2:STE 208
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4664
Mailing Address - Country:US
Mailing Address - Phone:402-758-5690
Mailing Address - Fax:402-758-5699
Practice Address - Street 1:16909 LAKESIDE HILLS CT
Practice Address - Street 2:STE 208
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4664
Practice Address - Country:US
Practice Address - Phone:402-758-5690
Practice Address - Fax:402-758-5699
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE287213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00477933OtherMEDICARE PIN
NE10025409500Medicaid
NE280251Medicare PIN