Shauna R Nelson, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

453 Issued in ND

Practice address

1711 Gold Dr S Ste 120
Fargo, ND 58103-6416

Phone

(701) 451-9417

NPI assigned

Jul 23, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Balance Physical Therapy and Fitness, LLCGroup PAC ID 8820356991, 37 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.38 of 100Reported as group

Quality

89.93

Improvement activities

40

Cost

81.37

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Balance Physical Therapy and Fitness, LLC

  • Physical Therapist
  • Fargo, ND
  • NPI 1588175061

  MN, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Total Balance Dietitian, LLC

  • Registered Dietitian
  • Fargo, ND
  • NPI 1255190534
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1003393000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "017-451-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 GOLD DR S STE 120",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036416",
            "telephone_number": "701-451-9417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Harwood Dr S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581046298",
            "country_code": "US",
            "telephone_number": "701-541-6621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHAUNA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3482838934",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole M Nelson, CRNA
• Nora Ann Nelson, MD
• Rachel Nelson, DC
• Rachel Dawn Nelson, LSW
• Roberta R Nelson, LAC
• Stacey Nelson, LAC
• Stephanie Nelson, NP
• Stephen N Nelson, MD
• Susan Nelson
• Susan Nelson

• Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.