Tyrel Nelson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5655 Issued in ID

Practice address

1120 Stocks Ave Ste C
Rexburg, ID 83440-3590

Phone

(208) 261-2123

NPI assigned

Jun 4, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 208 Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Rexburg, ID
  • NPI 1851016356
  Medicare reassignment NPD Authorized official
• Therapeutic Associates Inc

  • Physical Therapist
  • Boise, ID
  • NPI 1487630240
  Medicare reassignment NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Eagle, ID
  • NPI 1144636358
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Boise, ID
  • NPI 1326024472
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1477045581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 STOCKS AVE STE C",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403590",
            "telephone_number": "208-261-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TYREL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "5655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477045581",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Neibaur, D.P.T.
• Heather Nelson, RN
• Judy Nelson
• Terrance Nelson
• Trevor James Nelson, LCSW
• Rebecca NG
• Dennis V Nguyen, RD
• Mira Lee Nielson, LPC
• Night Boat PLLC
• Norco, Inc

• Physical Therapist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.