Evan Nelson

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4602 Eastpark Blvd
Madison, WI 53718-2002

Phone

(608) 440-6440

NPI assigned

Jul 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Freedom Physical Therapy Services SC

  • Physical Therapist
  • Fox Point, WI
  • NPI 1063406544
  NPD (past)

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1780884056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 UNIVERSITY AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537061510",
            "telephone_number": "608-265-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 EASTPARK BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182002",
            "telephone_number": "608-440-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6908 N Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Fox Point",
            "state": "WI",
            "postal_code": "532173942",
            "country_code": "US",
            "telephone_number": "414-352-2082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tbd",
            "affiliation": "N",
            "address_1": "4602 Eastpark Blvd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537182002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carl W Nelson, PHARM-D
• Christopher P Nelson, CRNA
• Clyde Joseph Nelson
• David Wade Nelson, O.D.
• Elisabeth Nelson, R.N.
• Heather Renee Nelson, LPN
• James Donald Dunham Nelson, DMD
• Kari Lynn Nelson, NP
• Katrina Nelson
• Kia Fay Nelson, MD

• Physical Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.