Active NPI
Thomas Richard Pierce Nelson, RBT
- Behavior Technician
- Charlotte, NC
National Provider Identifier
1043935166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-237392
- Practice address
- 716 Marsh Rd
Charlotte, NC 28209-1851 - Phone
- (704) 522-9912
- Fax
- (704) 566-6050
- NPI assigned
- Oct 11, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-237392 | NC | Primary |
Addresses
Primary practice location
716 Marsh Rd
Charlotte, NC 28209-1851
Mailing address
716 Marsh Rd
Charlotte, NC 28209-1851
Phone (704) 522-9912
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-237392 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1043935166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 MARSH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282091851",
"telephone_number": "704-522-9912",
"fax_number": "704-566-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 MARSH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282091851",
"telephone_number": "704-522-9912",
"fax_number": "704-566-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "THOMAS",
"middle_name": "RICHARD PIERCE",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-11",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": "RBT-22-237392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.