Active NPI
Roxann E. Nickerson, P.T.
- Pediatric Physical Therapist
- Andover, MA
National Provider Identifier
1023299922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1112
- Practice address
- 6 Hampton LN
Andover, MA 01810-4302 - Phone
- (978) 475-4450
- NPI assigned
- Nov 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1112 | MA | Primary |
Addresses
Primary practice location
6 Hampton LN
Andover, MA 01810-4302
Mailing address
6 Hampton LN
Andover, MA 01810-4302
Phone (978) 475-4450
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195430400000",
"number": "1023299922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 HAMPTON LN",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104302",
"telephone_number": "978-475-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 HAMPTON LN",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104302",
"telephone_number": "978-475-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKERSON",
"first_name": "ROXANN",
"middle_name": "E.",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-19",
"last_updated": "2007-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MA",
"license": "1112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
- Robert Peter Nelken, M.D.
- Neuropsychology Consultants, Inc
- Jo-Ann Elizabeth Newcomb, R.N.
- Iris Newman, LICSW
- Karen A. Newpower, M.A., CCC-SLP
- Tiffany Rae Noonan, LICSW, MSW
- Northeast Medical Associates, PC
- Northeast Orthopaedic Alliance PLLC
- Marie-Yacinthe Nowicki, NP
- Darcie Marie Nuttall, M.ED., LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.