Individual provider Active NPI

Pamela Ann Nelson, PT

  • Physical Therapist
  • Torrance, CA
National Provider Identifier
1356583405
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18539 Issued in CA
Practice address
3858 W Carson St
Suite 121
Torrance, CA 90503-6709
Phone
(310) 543-9333
Fax
(310) 405-0954
NPI assigned
Apr 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18539 CA Primary

Addresses

Primary practice location

3858 W Carson St
Suite 121
Torrance, CA 90503-6709

Mailing address

1601 N Sepulveda Blvd
Suite #144
Manhattan Beach, CA 90266-5111
Phone (310) 543-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130617000472 CA Practitioner - Physical Therapist in Private Practice 5092954347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
South Bay Sports Medicine Physical Therapy IncGroup PAC ID 0244262087, 6 clinicians

Practice addresses (Care Compare)

3878 W Carson St
Suite 100
Torrance, CA 90503-6707
Phone 31054346555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Sports Medicine Physical Therapy Inc. Physical Therapist CurrentSince Apr 1, 2014 Accepting new patients

Locations

3878 W Carson St
Ste 100
Torrance, CA 90503
Phone (310) 543-4655

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1356583405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N SEPULVEDA BLVD",
            "address_2": "SUITE #144",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665111",
            "telephone_number": "310-543-9333",
            "fax_number": "310-405-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3858 W CARSON ST",
            "address_2": "SUITE 121",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036709",
            "telephone_number": "310-543-9333",
            "fax_number": "310-405-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT18539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.

Verify at the official NPI Registry.