Individual provider Active NPI

Roy Garret Nelson Jr., PT, DPT, OCS, SCS

  • Physical Therapist
  • Spring, TX
National Provider Identifier
1093403248
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13012 Issued in MN
Practice address
19711 Stuebner Airline Rd Ste 2
Spring, TX 77379-5448
Phone
(701) 430-3040
NPI assigned
Apr 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1293900 TX
Sports Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251S0007X 1293900 TX
Physical Therapist 225100000X 13012 MN Primary

Addresses

Primary practice location

19711 Stuebner Airline Rd Ste 2
Spring, TX 77379-5448

Mailing address

19711 Stuebner Airline Rd Ste 2
Spring, TX 77379-5448
Phone (701) 430-3040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1293900TXMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1093403248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19711 STUEBNER AIRLINE RD STE 2",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773795448",
            "telephone_number": "701-430-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19711 STUEBNER AIRLINE RD STE 2",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773795448",
            "telephone_number": "701-430-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROY",
        "middle_name": "GARRET",
        "name_suffix": "Jr.",
        "credential": "PT, DPT, OCS, SCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1293900",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1293900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.