Active NPI
Brandi Nelson
- Gerontology Occupational Therapist
- Keller, TX
National Provider Identifier
1023488947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 110267
- Practice address
- 611 Medina Dr
Keller, TX 76248-7331 - Phone
- (817) 991-0489
- NPI assigned
- Oct 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 110267 | TX | Primary |
Addresses
Primary practice location
611 Medina Dr
Keller, TX 76248-7331
Mailing address
611 Medina Dr
Keller, TX 76248-7331
Phone (817) 991-0489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110267 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1023488947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 MEDINA DR",
"city": "KELLER",
"state": "TX",
"postal_code": "762487331",
"telephone_number": "817-991-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 MEDINA DR",
"city": "KELLER",
"state": "TX",
"postal_code": "762487331",
"telephone_number": "817-991-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "BRANDI",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-05",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "TX",
"license": "110267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.