Nicole Marie Powell, DPT, ATC, LAT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05010696A Issued in IN

Practice address

3600 W Bethel Ave
Muncie, IN 47304-5407

Phone

(765) 213-3870

NPI assigned

Oct 25, 2011

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment NPD

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1053697862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 S MOCK AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473025446",
            "telephone_number": "260-729-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407",
            "telephone_number": "765-213-3870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Pilgrim Blvd",
            "address_purpose": "LOCATION",
            "city": "Hartford City",
            "state": "IN",
            "postal_code": "473481382",
            "country_code": "US",
            "telephone_number": "765-348-4197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "DPT,  ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "05010696A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "99048667A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010696A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1103842746",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300088469",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npowell@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "410 Pilgrim Blvd",
            "city": "Hartford City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473481382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nancy Lynn Porter
• Pamela Lorene Porter, LCSW
• Sarah Ruth Porter, NP-C
• William Porter III, RBT
• Teanna Pounds
• Nora E Powell, OTR/L
• Kasie N Power, PA-C
• Jennifer Powers
• Xander Prater
• Jennifer Pratt, OT

• Physical Therapist in Muncie, IN
• Providers in Muncie, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.