Healthcare Provider Details

I. General information

NPI: 1477971141
Provider Name (Legal Business Name): MICHAEL BRADLEY NELSON M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLATHE BLVD SUITE 3B
KANSAS CITY KS
66160-2620
US

IV. Provider business mailing address

2106 OLATHE BLVD MAILSTOP 4004
KANSAS CITY KS
66160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax: 913-274-3515
Mailing address:
  • Phone: 913-588-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number04-43510
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number2024014447
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-43510
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: