Active NPI
Katrina Dawn Nelson, DPT
- Physical Therapist
- Tampa, FL
National Provider Identifier
1063789717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25843
- Practice address
- 3500 E Fletcher Ave Ste 110
Tampa, FL 33613-4789 - Phone
- (813) 977-7671
- NPI assigned
- Nov 23, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT25843 | FL | Primary |
Addresses
Primary practice location
3500 E Fletcher Ave Ste 110
Tampa, FL 33613-4789
Mailing address
11402 Buchanan LN
Seffner, FL 33584-4302
Phone (352) 210-0712
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 |
|---|---|---|---|
| PT25843 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1063789717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11402 BUCHANAN LN",
"city": "SEFFNER",
"state": "FL",
"postal_code": "335844302",
"telephone_number": "352-210-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 E FLETCHER AVE STE 110",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134789",
"telephone_number": "813-977-7671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KATRINA",
"middle_name": "DAWN",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-23",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT25843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.