TREVOR JAMES NELSON (LCSW) – Clinical Social Worker, NPI 1174971014

TREVOR JAMES NELSON (LCSW) is a healthcare provider. based in Rexburg, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LMSW-35746 (ID). The NPI Number for TREVOR JAMES NELSON (LCSW) is 1174971014

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
TREVOR JAMES NELSON (LCSW)
NPI
1174971014
Phone
(208) 359-4840
Address
393 E 2ND N
Enumeration Date
1 June 2016
Last Update Date
9 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082439304
Graduation Year
2016 (10 years ago)
PAC ID
1951749217
Group Practice PAC ID
8224476585
Professional Enrollment ID
I20240405001431
Address ID
ID834402057RE33XXXPARK400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:10State licenses:2Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

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Provider Addresses for TREVOR JAMES NELSON (LCSW)

  • 393, East 2nd North, Rexburg, Madison County, Idaho, 83440, United States

    REXBURG, ID 834401605

    Phone: (208) 359-4840

    Fax: (208) 359-9010

    Type: Mailing

  • 33 MADISON PROFESSIONAL PARK

    REXBURG, ID 834402057

    Phone: (208) 243-9304

    Fax: (208) 656-5668

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240405001431IClinical Social WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83440)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224476585View full group profile
NameSpecialtyState
Nurse PractitionerID

Reviews

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Frequently asked questions

Does TREVOR JAMES NELSON (LCSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — TREVOR JAMES NELSON (LCSW) uses 1174971014.
Does CMS list TREVOR JAMES NELSON (LCSW) as active?
Yes — TREVOR JAMES NELSON (LCSW) is active in the NPI listing used on this page.
What taxonomy line describes TREVOR JAMES NELSON (LCSW)?
For research purposes, treat TREVOR JAMES NELSON (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Does TREVOR JAMES NELSON (LCSW) list a practice location?
Patients near Rexburg, Idaho may find TREVOR JAMES NELSON (LCSW) in results; validate coverage separately.
Why does TREVOR JAMES NELSON (LCSW) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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