Active NPI
Teresa White-Nelson, PTA
- Physical Therapy Assistant
- St Petersburg, FL
National Provider Identifier
1780307967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 26618
- Practice address
- 521 Atwood Ave N
St Petersburg, FL 33702-6810 - Phone
- (727) 526-7000
- NPI assigned
- Sep 22, 2022
- 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 Therapy Assistant | 225200000X | 26618 | FL | Primary |
Addresses
Primary practice location
521 Atwood Ave N
St Petersburg, FL 33702-6810
Mailing address
1326 Bayou Pass Dr
Ruskin, FL 33570-5414
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 |
|---|---|---|---|
| 26618 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1780307967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1326 BAYOU PASS DR",
"city": "RUSKIN",
"state": "FL",
"postal_code": "335705414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 ATWOOD AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337026810",
"telephone_number": "727-526-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE-NELSON",
"first_name": "TERESA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "26618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.