Kyle Nelson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105169 Issued in MN

Practice address

2101 Wooddale Dr
Suite a
Woodbury, MN 55125-4441

Phone

(651) 738-9888

Fax

(651) 738-9889

NPI assigned

Aug 31, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175
  Medicare reassignment

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1386190064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR",
            "address_2": "SUITE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254441",
            "telephone_number": "651-738-9888",
            "fax_number": "651-738-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR",
            "address_2": "SUITE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254441",
            "telephone_number": "651-738-9888",
            "fax_number": "651-738-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sai Srushi Nelapati
• Laura Nelsen, L.P.
• Jennifer Nelson, MA, LPCC
• Kaitlyn Nelson
• Kirk Nelson, DC
• Logan Robert Nelson, PHARM.D.
• Nicole Marie Nelson, CRNA
• Rachel M Nelson
• Georgia Nesbitt, M.A.
• Sarah Nesheim

• Occupational Therapist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.