Kristopher S Nelson, MPT

Individual provider Active NPI Physical Therapist · Riverton, WY

NPI 1558375006 · NPPES record last updated Nov 9, 2007

Key facts

NPI
1558375006
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT975 (WY)
Practice address
2002 West Sunset Dr
Suite 1
Riverton, WY 82501
Phone
(307) 856-7021
Fax
(307) 856-5546
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fremont Therapy Group Limited Partnership (22 clinicians)

Practice addresses (Care Compare)

330 Upland Way
Green River, WY 82935-6401
Phone (307) 875-4654

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050805000877 WY Practitioner - Physical Therapist in Private Practice 7719916154 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical & Sports Therapy Green River, LLC Physical Therapist Current Accepting new patients
Fremont Therapy Group Limited Partnership Physical Therapist Current
since Apr 1, 2021
Accepting new patients
Fremont Therapy Group Limited Partnership Current
since Apr 1, 2021
Accepting new patients
Fremont Therapy Group LLC Physical Therapist Current
since Jul 18, 2005
Accepting new patients

Locations

330 Upland Way
Green River, WY 82935
Phone (307) 856-7021

8168 State Highway 789
Lander, WY 82520
Phone (307) 332-5240

2002 W Sunset Dr
Ste 1
Riverton, WY 82501
Phone (307) 856-7021

1401 Gateway Blvd
Unit 2
Rock Springs, WY 82901
Phone (307) 352-3626

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT975 WY Yes

Addresses

Primary practice location

2002 West Sunset Dr
Suite 1
Riverton, WY 82501

Mailing address

2002 West Sunset Dr
Suite 1
Riverton, WY 82501
Phone (307) 856-7021

Other identifiers

IdentifierTypeStateIssuer
313876OtherWYBLUE CROSS BLUE SHIELD

Other providers in Riverton, WY

All providers in Riverton, WY · Physical Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.