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Deactivated NPI 1720100266 Deactivated / Inactive NPI Male Practitioner

Dr. Jim Walter Nelson , MD

Contractor • Temecula, CA

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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, Dr. Jim Nelson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 04, 2007
NPI Deactivation Date August 04, 2017
Total Practice Duration ~10 Years of Practice (2007 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Jim Nelson, MD was a registered Contractor practicing in Temecula, CA. Throughout an active medical career spanning 10 years, Dr. Nelson provided care at the practice location at 27720 JEFFERSON AVE until profile deactivation on 2017-08-04.

Practice Location & Contact Primary Location

Practice Address

27720 Jefferson Ave
Suite 100

Temecula, CA 925902610

Telephone 9515069536
Fax 9516934631
Associated Practice Facility / Clinic
🏢 Whitson Family Therapy, Apc Facility NPI 1225169642

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Temecula, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
3 Specialists

Practicing in Temecula, CA (480 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

State License CA C26010

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Practice Associates & Co-Workers

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

8 Associated Practitioners
James Lauerman , PA

Physician Assistant

NPI 1083698245

Physician Assistant

Dr. Murad Arif , MD

Anesthesiology

NPI 1164925038

Doctor of Medicine (M.D.)

Dr. Jack Druet , MD

Anesthesiology - Pain Medicine

NPI 1265416424

Doctor of Medicine (M.D.)

Thomas Le

Radiologic Technologist - Radiography

NPI 1447118633
Hayden Brickle , PA

Physician Assistant - Medical

NPI 1528211331

Physician Assistant

Dr. Mark Austin , MD

Anesthesiology

NPI 1538699152

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated August 04, 2017

Record deactivated on August 04, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 27720 JEFFERSON AVE, SUITE 100, TEMECULA, CA 925902610 (Tel: 9515069536)

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Updated Business Mailing Address July 08, 2007

Registered at 12569 CAMINO VUELO, SAN DIEGO, CA 921281412 (Tel: 8586130309)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JIM NELSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Contractor (License #C26010 in CA)

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Initial NPI Registration & Enumeration April 04, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720100266
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 04, 2007
Last Update: July 08, 2007
Deactivation Date: August 04, 2017

Mailing Address

12569 Camino Vuelo

San Diego, CA 921281412

Phone: 8586130309

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.