Active NPI
Crystal Nelson, MS, OTR/L
- Ergonomics Occupational Therapist
- West Fargo, ND
National Provider Identifier
1366766107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ergonomics Occupational Therapist
- License
- 1082
- Practice address
- 345 11TH St W
West Fargo, ND 58078-1400 - Phone
- (701) 532-2222
- Fax
- (701) 552-7211
- NPI assigned
- Mar 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 1082 | ND | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 1082 | ND | |
| Ergonomics Occupational Therapist | 225XE1200X | 1082 | ND | Primary |
Addresses
Primary practice location
345 11TH St W
West Fargo, ND 58078-1400
Mailing address
345 11TH St W
West Fargo, ND 58078-1400
Phone (701) 532-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1082 | ND | MD | Ergonomics Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1366766107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 11TH ST W",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580781400",
"telephone_number": "701-532-2222",
"fax_number": "701-552-7211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 11TH ST W",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580781400",
"telephone_number": "701-532-2222",
"fax_number": "701-552-7211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CRYSTAL",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-23",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "ND",
"license": "1082",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "ND",
"license": "1082",
"primary": false
},
{
"code": "225XE1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Ergonomics",
"state": "ND",
"license": "1082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.