Active NPI
Chad Nelson, P.T.
- Physical Therapist
- Fort Myers, FL
National Provider Identifier
1699088112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 25664
- Practice address
- 2525 1St St
Fort Myers, FL 33901-2465 - Phone
- (239) 628-3105
- Fax
- (239) 332-0185
- NPI assigned
- Jul 26, 2010
- Last updated
- Jul 26, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 25664 | FL | Primary |
Addresses
Primary practice location
2525 1St St
Fort Myers, FL 33901-2465
Mailing address
23380 Sharon CT
Elkhart, IN 46517-9408
Phone (574) 606-7804
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25664 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1699088112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23380 SHARON CT",
"city": "ELKHART",
"state": "IN",
"postal_code": "465179408",
"telephone_number": "574-606-7804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 1ST ST",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339012465",
"telephone_number": "239-628-3105",
"fax_number": "239-332-0185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CHAD",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-26",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "25664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.