Terrance Devon Nelson, CPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG61250259 Issued in WA

Practice address

901 N Monroe St Ste 200
Spokane, WA 99201-2148

Phone

(509) 715-8302

Fax

(509) 241-1866

NPI assigned

Aug 15, 2022

Last updated

Aug 15, 2022By the provider in NPPES

Sex

Male

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: terrance@revivespokane.com

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1073241279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 E FREDERICK AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992177063",
            "telephone_number": "509-638-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-715-8302",
            "fax_number": "509-241-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TERRANCE",
        "middle_name": "DEVON",
        "name_prefix": "Mr.",
        "credential": "CPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61250259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CG61250259",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Terrance@revivespokane.com",
            "affiliation": "Y",
            "endpointDescription": "Secured Email",
            "affiliationName": "Revive Counseling Spokane, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "901 N Monroe St Ste 200",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992012148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon J Nelson, MA
• Shelley Ann Nelson, CDP
• Stacy Nelson
• Tanya Rene Nelson, C.P.S/ R.A.C
• Taylor Jordan Nelson, OTD, OTR/L
• Ty-Michael Orlan Nelson, OTD, OTR/L
• Vanessa Nelson
• Wendy Lynn Nelson, MS
• William F. Nelson, D.O.
• Nikki Nemeth

• Peer Specialist in Spokane, WA
• Providers in Spokane, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.