CORY NELSON (D.O.) – Sports Medicine (Family Medicine) Physician, NPI 1124339460

CORY NELSON (D.O.) is a healthcare provider. based in South jordan, Utah. specializing in SPORTS MEDICINE. They hold the professional credentials D.O.. They hold a License No. 8591638-1204 (UT). The NPI Number for CORY NELSON (D.O.) is 1124339460

Main info

Male
Sole Proprietor
16 Years Of Experience
Accepts Medicare Assignment
Name
CORY NELSON (D.O.)
NPI
1124339460
Phone
(801) 543-9264
Address
1577 W WYNVIEW LN
Enumeration Date
1 July 2010
Last Update Date
8 September 2021

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
8017537770
Graduation Year
2010 (16 years ago)
PAC ID
0446499206
Group Practice PAC ID
6204140122
Professional Enrollment ID
I20130627000097
Address ID
UT840437497LE3401XSTXX401

Contacts

Secure Messaging
cory.nelson@direct.imail.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness85
Years active:15State licenses:2Other namesUpdated within 12 months

105 SPORTS MEDICINE in UT

Provider Addresses for CORY NELSON (D.O.)

  • 1577 W WYNVIEW LN

    SOUTH JORDAN, UT 840958480

    Phone: (801) 543-9264

    Type: Mailing

  • 3943 E Pony Express Pkwy Ste 210

    Eagle Mountain, UT 840055544

    Phone: (801) 789-3030

    Fax: (801) 789-3039

    Type: Location

  • 3401 N CENTER ST STE 100

    LEHI, UT 840437498

    Phone: (801) 753-7770

    Fax: (801) 753-7775

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $102.

Total Amount is formed as General ($102) + Research ($0) + Ownership ($0) = $102.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Orthofix Medical, Inc. ($25).

Total Amount

$102

General + Research + Ownership

Payments

5

Total payment records

General Amount

$102

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2013-06-27

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
I20130627000097ISports MedicineUTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg27326$0
20610Aspiration and/or injection of fluid from large joint6917$0
99214Established patient office or other outpatient visit, 30-39 minutes5328$0
99204New patient office or other outpatient visit, 45-59 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 84095)

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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: 6204140122View full group profile
NameSpecialtyState
Sports MedicineUT
Physical Medicine And RehabilitationTX
Orthopedic Surgery, Sports MedicineMS
Family PracticeIN
Sports Medicine, Family PracticeUT
Family Practice, Sports MedicineWY

Reviews

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Frequently asked questions

What unique ID ties claims to CORY NELSON (D.O.)?
NPI 1124339460 is assigned to CORY NELSON (D.O.) under the national enumeration system.
Is CORY NELSON (D.O.) currently active in the NPI registry?
CMS-published data lists CORY NELSON (D.O.) as an active registrant.
What does CORY NELSON (D.O.) treat or focus on?
Patients typically see CORY NELSON (D.O.) under the specialty Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where is CORY NELSON (D.O.)'s primary listing?
We display South Jordan, Utah because that is what the record indicates for CORY NELSON (D.O.).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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