Active NPI
Brett Robert Nelson, P.T.
- Physical Therapist
- Mount Vernon, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009227
- Practice address
- 1401 S Laventure Rd
Mount Vernon, WA 98274-6033 - Phone
- (360) 424-2400
- Fax
- (360) 424-2418
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- 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 | PT00009227 | WA | Primary |
Addresses
Primary practice location
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Mailing address
805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 187754 | Other | WA | LABOR AND INDUSTRIES |
| 8334245 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 Continental PL
Mount Vernon, WA 98273-4105
Phone (360) 424-7041
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6866 | WA | MD | General Practice Dentistry |
| PT00009227 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Current | Accepting new patients | |
| Proliance Surgeons, Inc., P.S. | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Current | Accepting new patients |
Locations
1017 20th St
Anacortes, WA 98221
Phone (360) 424-7041
1500 Continental Pl
Mount Vernon, WA 98273
Phone (360) 424-7041
1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
- Orthopaedic Surgery Physician
- Lakewood, WA
- NPI 1891799490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1114926466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 MADISON ST",
"address_2": "SUITE 901",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041172",
"telephone_number": "206-264-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 S LAVENTURE RD",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982746033",
"telephone_number": "360-424-2400",
"fax_number": "360-424-2418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "BRETT",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009227",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "187754",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8334245",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.