Michelle Renee Nelson, C.O.T.A

Primary specialty

SpecialistTaxonomy code 174400000X

License

OTA-689 Issued in CA

Practice address

4525 W Tulare Ave
Visalia, CA 93277-1560

Phone

(530) 781-4005

NPI assigned

Aug 26, 2010

Last updated

Aug 26, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Michelle Renee Tracy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1174839344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19601 CHEROKEE ROAD",
            "address_2": "P.O. BOX 435",
            "city": "TUOLUMNE",
            "state": "CA",
            "postal_code": "953790435",
            "telephone_number": "209-928-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 W TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932771560",
            "telephone_number": "530-781-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "C.O.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OTA-689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "TRACY",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "C.O.T.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Daniel Negron
• Jennifer Nelsen, AGACNP
• Cory Nelson, PHARM.D.
• Deidra Nelson
• Gail Rosanne Nelson, MSW, LCSW
• Pamela E Nelson, MS, CRC
• Terry Blake Nelson, DPM
• Zachary Tyler Nelson
• Guadalupe Angelina Neria
• Janel Ann Neufeld, MS

• Specialist in Visalia, CA
• Providers in Visalia, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.