Provider Demographics
NPI:1477971141
Name:NELSON, MICHAEL BRADLEY (MD, MPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BRADLEY
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 OLATHE BLVD MAILSTOP 4004
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-5000
Mailing Address - Fax:
Practice Address - Street 1:2000 OLATHE BLVD
Practice Address - Street 2:SUITE 3B
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-2620
Practice Address - Country:US
Practice Address - Phone:913-588-6300
Practice Address - Fax:913-274-3515
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-435102080P0216X, 208000000X
MO20240144472080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric RheumatologyGroup - Multi-Specialty