DR. JESSIE MARIE NELSON MD, MS
NPI 1730936253
General Practice in Detroit, MI

Q: What is Jessie Nelson's NPI number?

The NPI number for Jessie Nelson is 1730936253. It was assigned to this individual provider in the NPPES registry on May 2, 2024.

Q: What is Jessie Nelson's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Jessie Nelson was last updated on December 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 May 02, 2024PECOS Enrolled

2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-1032 Get Directions Write a Review

NPPES record last updated: December 28, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 28, 2025, Jun 30, 2025, May 2, 2024 (3 updates tracked since 2024).

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About Dr. Jessie Marie Nelson Md, Ms NPPES

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

DR. JESSIE MARIE NELSON MD, MS (NPI 1730936253) is an individual general practice provider in Detroit, Michigan, licensed in Michigan (4351052706) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Ann Arbor, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1730936253

Entity TypeIndividualFemale

Primary Taxonomy208D00000X

Provider Legal NameDR. JESSIE MARIE NELSONCredential: MD, MS

Location Address2799 W GRAND BLVDDetroit, MI 48202-2689

Mailing Address2799 W Grand BlvdDetroit, MI 48202-2689 · (313) 916-1032

Phone(313) 916-1032

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateMay 2, 2024

Last NPPES UpdateDecember 28, 20253 updates tracked since enumeration

NPPES CertifiedDecember 28, 2025

✔ NPI 1730936253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in MI · 4351052706

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 4351052706 (MI)

2799 W GRAND BLVD, Detroit, MI 48202

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Secondary Practice Location 1

Location 11500 E. Medical Center Drive, SPC 5332, Taubman Center, 2nd Floor, Reception FAnn Arbor, MI 48109-5332 · Phone (734) 936-5738 · Fax (734) 936-6927

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jessie Marie Nelson Md, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719328640

PECOS Enrollment IDI20260601001296

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.

Other Providers at the Same Location NPPES 20

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

HENRY FORD HOSPITAL

General Acute Care Hospital