MICHAEL NELSON (NPI# 1134608144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134608144 |
| Entity Type | Individual |
| Full Name | MICHAEL NELSON |
| Credential | PT, DPT |
| Practice Address |
1111 Crater Lake Ave Medford OR 97504-6241 |
| Mailing Address |
3073 Ruby Dr Medford OR 97504-3633 |
| Practice Telephone | 5417321111 |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
61681 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251N0400X |
Physical Therapist Specialization: Neurology |
61681 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669970638 | Michael Steven Nelson | Marriage & Family Therapist | 2423 Camino Del Rio S Ste 105, San Diego, CA 92108-3734 | 2018-01-25 |
| 1477065829 | Michael Nelson | Contractor | 4719 Cooper St, Albany, GA 31705-6009 | 2017-10-25 |
| 1275060410 | Michael Nelson | Chiropractor | 2147 Nw Highway 101, Lincoln City, OR 97367-4254 | 2017-05-18 |
| 1639536717 | Michael Nelson | Chiropractor | 10623 Professional Cir, Suite A, Reno, NV 89521-5846 | 2016-01-20 |
| 1477971141 | Michael Bradley Nelson | Pediatrics | 2000 Olathe # 3b, Kansas City, KS 66160-2620 | 2014-03-31 |
| 1699018192 | Michael Nelson | Dentist | 2803 176th Ave East, Lake Tapps, WA 98391 | 2013-04-03 |
| 1922343714 | Michael Nelson | Physical Therapist | 18501 N Thompson Peak Pkwy, Scottsdale, AZ 85255-6087 | 2012-12-05 |
| 1487971198 | Michael Nelson | Counselor | 11777 Sebastian Way Ste 102, Rancho Cucamonga, CA 91730-0707 | 2010-04-21 |
| 1730354622 | Michael Joseph Nelson Sr. | Registered Nurse | 7445 University Ave, Clive, IA 50325-1337 | 2008-04-23 |
| 1487787115 | Michael Earl Nelson | Dentist | 2025 W Elk Ave, Suite A, Duncan, OK 73533-1602 | 2007-03-13 |
| Street Address |
1111 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558361378 | Craig S. Thalacker | Emergency Medicine | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2005-07-22 |
| 1447865464 | Annabel M Walker | Nurse Practitioner | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2020-09-15 |
| 1386256519 | Ryan Tierney | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2020-08-19 |
| 1992362867 | Courtney Howarth | Physical Therapy Assistant | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2019-05-24 |
| 1811470107 | Nicole Marie Choyce | Dietitian, Registered | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-09-12 |
| 1336621721 | Tai Bailey Shelton | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-31 |
| 1932681533 | Jacqueline Lucas-morris | Occupational Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-30 |
| 1477035236 | Sarah Rae Hanley | Occupational Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-29 |
| 1306327242 | Elizabeth Carlton | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-28 |
| 1851872428 | Ida Marielke Funke | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 2251N0400X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Neurology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366921652 | Carolyn A Piatt | Physical Therapist | 1111 Crater Lake Ave, Medford, OR 97504-6241 | 2018-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073667218 | Oregon Neurosport Physical Therapy | Physical Therapist | 680 Ivy St, Junction City, OR 97448-1636 | 2007-01-23 |
| 1801425269 | Andrea Susan Serdar | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-06 |
| 1730718768 | Marvin C Smith | Physical Therapist | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2020-04-02 |
| 1992334924 | Mackenzie Root | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-02 |
| 1396374328 | Jeffrey Schlimgen | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-02 |
| 1578041661 | Jaime Musgrave | Physical Therapist | 9135 Sw Barnes Rd, Ste 361, Portland, OR 97225-9720 | 2018-08-01 |
| 1851841993 | Whitney Ann Gray | Physical Therapist | 3270 Liberty Rd S, Salem, OR 97302-4560 | 2016-10-13 |
| 1629420534 | Courtney Lewis | Physical Therapist | 507 Ne 47th Ave, Portland, OR 97213-2236 | 2016-07-05 |
| 1669894275 | Janell Wyatt | Physical Therapist | 1700 E 19th St, Mcmc Physical Therapy Dept./ M-power Rehab, The Dalles, OR 97058-3317 | 2014-01-16 |
| 1205267754 | Carly Lochala | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2013-12-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.