Paul Nelson, PTA/L

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306603748 Issued in VA

Practice address

11 Dairy Lane
Fredericksburg, VA 22554

Phone

(860) 748-2108

NPI assigned

Nov 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1679903157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LAKESEDGE LN",
            "address_2": "APT. 104",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547509",
            "telephone_number": "860-748-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DAIRY LANE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "860-748-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603748",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000346",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "3385",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "0576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathryn Lee Nesmith, FNP-C
• Gabriele Neumaier-Farnsworth, LCSW
• Emily Rose Neumann, COTA
• Neurofeedback and Brain Fitness Center, LLC

• Physical Therapy Assistant in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.