Active NPI
Cheryl S Nelson, O.T.
- Occupational Therapist
- Avondale, AZ
National Provider Identifier
1114142445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 10450 W McDowell Rd
Ste 102
Avondale, AZ 85392-4802 - Phone
- (623) 848-4687
- Fax
- (623) 848-4686
- NPI assigned
- Apr 13, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
10450 W McDowell Rd
Ste 102
Avondale, AZ 85392-4802
Mailing address
PO Box 29870
Phoenix, AZ 85038-9870
Phone (602) 772-3805
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00845668 | Other | AZ | RAILROAD MEDICARE |
| 3Z3990 | Other | HEALTHNET ID | |
| 637738 | Medicaid | AZ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1667 | AZ | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1114142445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29870",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850389870",
"telephone_number": "602-772-3805",
"fax_number": "602-772-3801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10450 W MCDOWELL RD",
"address_2": "STE 102",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853924802",
"telephone_number": "623-848-4687",
"fax_number": "623-848-4686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CHERYL",
"middle_name": "S",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00845668",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET ID",
"identifier": "3Z3990",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "637738",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.