JOHN DOUG NELSON M.D.
NPI 1528047248
Family Medicine in Asheville, NC

Q: What is John Nelson's NPI number?

The NPI number for John Nelson is 1528047248. It was assigned to this individual provider in the NPPES registry on January 11, 2006.

Q: What is John Nelson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for John Nelson was last updated on December 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 11, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

90 SOUTHSIDE AVE, SUITE 350, ASHEVILLE, NC 28801(828) 277-4810 Get Directions Write a Review

NPPES record last updated: December 7, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About John Doug Nelson M.d. NPPES

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

JOHN DOUG NELSON M.D. (NPI 1528047248) is an individual family medicine provider in Asheville, North Carolina, licensed in North Carolina (31342) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Caromont Regional Medical Center, and is a graduate of Louisiana State University School Of Medicine In Shreveport (1983).

NPPES Registry Identity

NPI1528047248

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJOHN DOUG NELSONCredential: M.D.

Location Address90 SOUTHSIDE AVE, SUITE 350Asheville, NC 28801-4160

Mailing Address90 Southside Ave, Suite 350Asheville, NC 28801-4160

Phone(828) 277-4810

Sole ProprietorNo

Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 1983

Enumeration DateJanuary 11, 2006

Last NPPES UpdateDecember 7, 2016

✔ NPI 1528047248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NC · 31342

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License 31342 (NC)

90 SOUTHSIDE AVE, Asheville, NC 28801

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Other Identifiers 4

Medicare UPINC85724

Medicaid8962098NC

Other62098NC · Bcbsnc

Medicare PINNC6063CNC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, Oscar Health Plan of North Carolina, Inc.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

John Doug Nelson M.d. 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 ID1456249374

PECOS Enrollment IDI20050401000627

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 John Nelson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wake Forest Health Network LLC

65 mi

Family Medicine

ONE TRADE STREET
Granite Falls, NC 28630

Reassigned Medicare billing, North Carolina enrollment
583 clinicians in this Medicare group

NPI 1770858938 (828) 396-3136

Geriatric Consultants PLLC

69 mi

Geriatric Medicine

220 13TH AVENUE PL NW
Hickory, NC 28601

Reassigned Medicare billing, North Carolina enrollment
67 clinicians in this Medicare group

NPI 1801478086 (914) 843-9637

Curana Health Of North Carolina PLLC

202 mi

Internal Medicine

5306 NC HIGHWAY 55 STE 105
Durham, NC 27713

Reassigned Medicare billing, North Carolina enrollment
338 clinicians in this Medicare group

NPI 1770217176 (337) 408-0797

Physicians Eldercare PA

202 mi

General Practice

5306 NC HIGHWAY 55 STE 105
Durham, NC 27713

Reassigned Medicare billing, North Carolina enrollment
365 clinicians in this Medicare group

NPI 1023083268 (337) 991-9276

Careconnectmd North Carolina P.C.

207 mi

General Practice

555 S MANGUM ST STE 100
Durham, NC 27701

Reassigned Medicare billing, North Carolina enrollment
60 clinicians in this Medicare group

NPI 1104507441 (888) 789-9585

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 20

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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

1,347 services380 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

1,087 services383 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

821 services106 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

365 services299 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

283 services121 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

283 services232 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

157 services56 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

157 services79 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

78 services50 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

41 services37 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

39 services31 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

38 services34 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

37 services35 patients

Advance care planning, first 30 minutes 99497

32 services30 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

30 services15 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

28 services25 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

16 services16 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

15 services15 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

14 services12 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

12 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Caromont Regional Medical Center

Acute Care Hospitals · Gastonia, NC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340032

Location2525 Court DrGastonia, NC 28052 · Gaston County

Emergency services Birthing friendly

Caldwell Memorial Hospital

Acute Care Hospitals · Lenoir, NC

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340041

Location321 Mulberry St SWLenoir, NC 28645 · Caldwell County

Emergency services

Blue Ridge Healthcare Hospitals, Inc

Acute Care Hospitals · Morganton, NC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number340075

Location2201 S Sterling StMorganton, NC 28655 · Burke County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28801 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

75/100

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

Scored as part of a group practice

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…

100%708 patients5/55-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 33

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

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

3 suppliers44 claims44 services$22.76 avg. paid by Medicare

Urinary catheter anchoring device, adhesive skin attachment, each A4333

DME-Orthotic Devices · category DF000N

2 suppliers60 claims720 services$1.93 avg. paid by Medicare

Urinary catheter anchoring device, leg strap, each A4334

DME-Orthotic Devices · category DF000N

1 supplier25 claims25 services$4.57 avg. paid by Medicare

Intermittent urinary catheter, with insertion supplies A4353

DME-Orthotic Devices · category DF008N

1 supplier13 claims1,170 services$6.77 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

2 suppliers67 claims86 services$8.39 avg. paid by Medicare

Ostomy skin barrier, powder, per oz A4371

DME-Orthotic Devices · category DF010N

2 suppliers17 claims17 services$3.12 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each A4414

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$4.05 avg. paid by Medicare

Tape, non-waterproof, per 18 square inches A4450

DME-Medical/Surgical Supplies · category DA000N

2 suppliers26 claims1,804 services$0.10 avg. paid by Medicare

Tape, waterproof, per 18 square inches A4452

DME-Medical/Surgical Supplies · category DA000N

1 supplier51 claims8,504 services$0.37 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

2 suppliers12 claims600 services$0.23 avg. paid by Medicare

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063

DME-Orthotic Devices · category DF010N

2 suppliers17 claims330 services$2.42 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

2 suppliers18 claims875 services$0.22 avg. paid by Medicare

Collagen based wound filler, dry form, sterile, per gram of collagen A6010