Active NPI
Jeffrey S Nelson, PT
- Physical Therapist
- Oceanside, CA
National Provider Identifier
1306942255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29862
- Practice address
- 2322 Carriage Cir
Oceanside, CA 92056-3604 - Phone
- (818) 209-8888
- Fax
- (949) 404-6914
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 29862 | CA | Primary |
Addresses
Primary practice location
2322 Carriage Cir
Oceanside, CA 92056-3604
Mailing address
2322 Carriage Cir
Oceanside, CA 92056-3604
Phone (818) 209-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29862 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050218000792 | CA | Practitioner - Physical Therapist in Private Practice | 4587616487 | Practice locations: Oceanside, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1306942255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2322 CARRIAGE CIR",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920563604",
"telephone_number": "818-209-8888",
"fax_number": "949-404-6914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2322 CARRIAGE CIR",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920563604",
"telephone_number": "818-209-8888",
"fax_number": "949-404-6914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JEFFREY",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "29862",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "29862",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.