DONALD R NELSON MD
NPI 1427036813
Internal Medicine in Dublin, GA

Q: What is Donald Nelson's NPI number?

The NPI number for Donald Nelson is 1427036813. It was assigned to this individual provider in the NPPES registry on January 5, 2006.

Q: What is Donald Nelson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Nelson was last updated on May 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 05, 2006PECOS EnrolledAccepts Medicare Assignment

74.51/100

CMS Quality Rating

104 FAIRVIEW PARK DR, DUBLIN, GA 31021(478) 272-1366(478) 277-1922 Get Directions Write a Review

NPPES record last updated: May 4, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Donald R Nelson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DONALD R NELSON MD (NPI 1427036813) is an individual internal medicine provider in Dublin, Georgia, licensed in Georgia (024847) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Fairview Park Hospital, and is a graduate of Medical College Of Georgia School Of Medicine (1981).

NPPES Registry Identity

NPI1427036813

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDONALD R NELSONCredential: MD

Location Address104 FAIRVIEW PARK DRDublin, GA 31021

Mailing AddressPo Box 1528Dublin, GA 31040-1528 · (478) 272-1366 · Fax (478) 277-1922

Phone(478) 272-1366

Fax(478) 277-1922

Sole ProprietorNo

Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1981

Enumeration DateJanuary 5, 2006

Last NPPES UpdateMay 4, 2021

NPPES CertifiedMay 4, 2021

✔ NPI 1427036813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 024847

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X · License 024847 (GA)

104 FAIRVIEW PARK DR, Dublin, GA 31021

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Other Identifiers 6

Other52048975-002GA · Bcbs

Medicaid000290089CGA

Other5110781GA · First Health

Other1459269GA · United Healthcare

Other5839179GA · Aetna

OtherP00688224GA · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Donald R Nelson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416995725

PECOS Enrollment IDI20081222000148

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Donald Nelson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cogent Healthcare Of Georgia PC

49 mi

Internal Medicine

400 CHARTER BLVD
Macon, GA 31210

Reassigned Medicare billing, Georgia enrollment
635 clinicians in this Medicare group

NPI 1609827823 (478) 757-8200

Curana Health Of Georgia LLC

122 mi

Internal Medicine

3355 LENOX RD NE STE 750
Atlanta, GA 30326

Reassigned Medicare billing, Georgia enrollment
69 clinicians in this Medicare group

NPI 1043605314 (337) 408-0797

Ch Specialty Services Ga LLC

122 mi

Internal Medicine

3355 LENOX RD NE STE 750
Atlanta, GA 30326

Reassigned Medicare billing, Georgia enrollment
71 clinicians in this Medicare group

NPI 1306545181 (337) 991-9276

Curana Health Medical Group LLC

886 mi

Internal Medicine

8911 N CAPITAL OF TEXAS HWY STE 1110
Austin, TX 78759

Reassigned Medicare billing, Georgia enrollment
79 clinicians in this Medicare group

NPI 1255640678 (337) 991-9276

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

1,300 services162 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

596 services137 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

171 services161 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

162 services158 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Fairview Park Hospital

Acute Care Hospitals · Dublin, GA

5/5 CMS rating

OwnershipProprietary

CMS Certification Number110125

Location200 Industrial BoulevardDublin, GA 31021 · Laurens County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.51/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

79.03

Promoting Interoperability

100

Improvement Activities

Cost

19.35

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

65%299 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

5 suppliers35 claims35 services$65.94 avg. paid by Medicare

Commode chair, mobile or stationary, with fixed arms E0163

DME-Other DME · category DE000N

3 suppliers30 claims30 services$76.66 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

3 suppliers65 claims65 services$70.60 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers77 claims77 services$18.25 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers77 claims77 services$109.85 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

3 suppliers138 claims138 services$26.45 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRIDE R CHAPMAN MD

Internal Medicine