Individual provider Active NPI

Gregory G Nelson

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1568841245
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
328625-2401 Issued in UT
Practice address
3257 E 3300 S
Salt Lake City, UT 84109-2246
Phone
(801) 716-2289
NPI assigned
May 27, 2015
Last updated
May 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2015

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 328625-2401 UT Primary

Addresses

Primary practice location

3257 E 3300 S
Salt Lake City, UT 84109-2246

Mailing address

3257 E 3300 S
Salt Lake City, UT 84109-2246
Phone (801) 716-2289

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
328625-2401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1568841245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3257 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092246",
            "telephone_number": "801-716-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841092246",
            "telephone_number": "801-716-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "GREGORY",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "328625-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.