Active NPI
Kristal Kay Nelson, PT
- Physical Therapist
- Fuquay Varina, NC
National Provider Identifier
1710937149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7450
- Practice address
- 100 Fitness Dr
Fuquay Varina, NC 27526-7263 - Phone
- (919) 557-3100
- Fax
- (919) 557-3177
- NPI assigned
- May 10, 2006
- Sex
- Female
- 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 | 7450 | NC | Primary |
Addresses
Primary practice location
100 Fitness Dr
Fuquay Varina, NC 27526-7263
Mailing address
PO Box 1492
Fuquay Varina, NC 27526-1492
Phone (919) 557-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078ET | Other | NC | BCBS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1710937149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1492",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275261492",
"telephone_number": "919-557-3100",
"fax_number": "919-557-3177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FITNESS DR",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275267263",
"telephone_number": "919-557-3100",
"fax_number": "919-557-3177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KRISTAL",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "7450",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "078ET",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.