Active NPI
Theresa M Nelson, OTR/L
- Occupational Therapist
- Charleston, SC
National Provider Identifier
1104227552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 428
- Practice address
- 505A Arlington Dr
Charleston, SC 29414-5006 - Phone
- (843) 763-1510
- Fax
- (843) 769-2598
- NPI assigned
- Sep 4, 2014
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 428 | SC | Primary |
Addresses
Primary practice location
505A Arlington Dr
Charleston, SC 29414-5006
Mailing address
75 Calhoun St
Charleston, SC 29401-5006
Phone (843) 937-6514
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 |
|---|---|---|---|
| 428 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417996800000",
"number": "1104227552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 CALHOUN ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015006",
"telephone_number": "843-937-6514",
"fax_number": "843-769-2598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505A ARLINGTON DR",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294145006",
"telephone_number": "843-763-1510",
"fax_number": "843-769-2598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "THERESA",
"middle_name": "M",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2014-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.