Jacob E Nelson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6699 W Rio Grande Ave
Kennewick, WA 99336-3301

Phone

(509) 460-5588

Fax

(509) 783-5438

NPI assigned

Jun 29, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Jake Nelson Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tri-City Orthopaedic Clinic, P S C

  • Orthopaedic Surgery Physician
  • Kennewick, WA
  • NPI 1215020144

  Physical Therapist

  Medicare reassignment NPD
• Tri-City Orthopaedic Clinic P S C

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1720495708
  NPD

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1154842136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 W KENNEWICK AVE # 550",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362927",
            "telephone_number": "509-783-8977",
            "fax_number": "509-783-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363301",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 Goethals Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523527",
            "country_code": "US",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6703 W Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993362623",
            "country_code": "US",
            "telephone_number": "509-460-5588",
            "fax_number": "509-783-5438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACOB",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT60770297",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "NELSON",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Navdeep S Virk DDS PLLC
• Corey Nay, D.C.
• Lisa Marie Neal, L.M.T.
• Casey Neiffer, PTA
• Alexander Scott Nelson, MSW
• Julianne Nelson, PHARMD
• Kerry Nelson
• Kevin Jun Nelson, DPT
• Kimberlee Kay Nelson, LMP
• Sara A Nelson, PT

• Physical Therapist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.