Individual provider Active NPI

Telan G Nelson, PT

  • Physical Therapist
  • Folsom, CA
National Provider Identifier
1528304789
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38927 Issued in CA
Practice address
705 Gold Lake Dr Ste 350
Folsom, CA 95630-2558
Phone
(916) 939-6800
Fax
(916) 939-6874
NPI assigned
Dec 17, 2012
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 PT38927 CA Primary

Addresses

Primary practice location

705 Gold Lake Dr Ste 350
Folsom, CA 95630-2558

Mailing address

705 Gold Lake Dr Ste 350
Folsom, CA 95630-2558
Phone (916) 939-6800

Other names 1

  • Telan Jean Greenlee Former name

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

State licenses

LicenseStateTypeSpecialty
38927CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Milestone Physical Therapy Inc Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Fit for Life Physical Therapy, Inc Physical Therapist PastSince Jul 18, 2016 Accepting new patients
Evolve Performance & Wellness a Diaz Chiropractic Professional Cor PastSince May 20, 2023 Accepting new patients
Thrive NC Physical Therapy, Inc. Physical Therapist PastSince Oct 1, 2016 Accepting new patients
Body Concepts, Inc. Past Accepting new patients

Locations

140 Diamond Creek Pl
Ste 125
Roseville, CA 95747
Phone (916) 206-3612

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1528304789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 GOLD LAKE DR STE 350",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302558",
            "telephone_number": "916-939-6800",
            "fax_number": "916-939-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GOLD LAKE DR STE 350",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302558",
            "telephone_number": "916-939-6800",
            "fax_number": "916-939-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TELAN",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT38927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TELAN",
            "last_name": "GREENLEE",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.