Forrest Nelson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-44515 Issued in FL

Practice address

8359 Beacon Blvd Ste 416
Fort Myers, FL 33907-3065

Phone

(239) 218-9557

NPI assigned

May 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Infinite Spectrum Supports

  • Behavior Analyst
  • Lehigh Acres, FL
  • NPI 1811663800
  NPD Authorized official

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1720515588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8359 BEACON BLVD STE 416",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073065",
            "telephone_number": "239-218-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 BEACON BLVD STE 416",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073065",
            "telephone_number": "239-218-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "FORREST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-44515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Kathleen Nelson, CRNA
• Brian Ward Nelson, RPH
• Chad Nelson, P.T.
• Chandra Nelson, RDN
• Ericka Blaufuss Nelson, ARNP
• Gretchen Nelson, ARNP
• Jasen Nelson
• Kayla Nelson, SLP-CCC
• Shannon L Nelson, CCC-SLP
• Tegan Leigh Nelson, PT

• Behavior Analyst in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.