Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1760735880 Deactivated / Inactive NPI Male Practitioner

Raice R Nelson , PA-C

Physician Assistant • Kingman, AZ

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Raice Nelson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 26, 2012
NPI Deactivation Date August 10, 2022
Total Practice Duration ~10 Years of Practice (2012 – 2022)

Professional Overview & Biography Verified Profile Summary

Raice Nelson, PA-C was a registered Physician Assistant practicing in Kingman, AZ. Throughout an active medical career spanning 10 years, Raice Nelson provided care at the practice location at 3269 STOCKTON HILL RD until profile deactivation on 2022-08-10.

Historical Medicare Part B clinical services included emergency department visit with low level of medical decision making, emergency department visit with moderate level of medical decision making, emergency department visit for life threatening or functioning severity. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3269 Stockton Hill Rd

Kingman, AZ 864093619

Telephone 9287570645
Fax 3862747801
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Kingman, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.9 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
21 Specialists

Practicing in Kingman, AZ (3711 Statewide)

Telehealth Adoption Rate
19.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
88.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99283 Emergency department visit with low level of medical decision making
13 12 $479.00 $53.52

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License AZ 5314

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
Tonya Allen , NP

Nurse Practitioner

NPI 1104254952

Nurse Practitioner

Dr. Elizabeth Miller , MD

Emergency Medicine

NPI 1215166749

Doctor of Medicine (M.D.)

Jennifer Azbill , PA-C

Physician Assistant

NPI 1225381858

Physician Assistant (Certified)

Yara Agostini , ARNP

Nurse Practitioner - Family

NPI 1275944696

Advanced Registered Nurse Practitioner

Dr. Wesley George , MD

Emergency Medicine

NPI 1295077584

Doctor of Medicine (M.D.)

Alexander Yates

Nurse Practitioner - Family

NPI 1306373022

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated August 10, 2022

Record deactivated on August 10, 2022

NPI Profile Active November 12, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location November 12, 2012

Registered at 3269 STOCKTON HILL RD, KINGMAN, AZ 864093619 (Tel: 9287570645)

📍
Updated Business Mailing Address November 12, 2012

Registered at PO BOX 11577, DAYTONA BEACH, FL 321201577 (Tel: 3862747800)

👤
Provider Name / Credentials Updated November 12, 2012

Recorded as RAICE NELSON, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2012

Physician Assistant (License #5314 in AZ)

🟢
Initial NPI Registration & Enumeration October 26, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Raice Nelson. Be the first to share your experience!

Sign in to leave a review for Raice Nelson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1760735880
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 26, 2012
Last Update: November 12, 2012
Deactivation Date: August 10, 2022

Mailing Address

Po Box 11577

Daytona Beach, FL 321201577

Phone: 3862747800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.