Carol W. Nicholson, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003123L Issued in PA

Practice address

Riverstreet Manor
440 North Main Street
Wilkes Barre, PA 18702

Phone

(570) 825-5611

NPI assigned

Mar 22, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063538908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 E VAUGHN ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044817",
            "telephone_number": "570-288-5344",
            "fax_number": "570-283-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIVERSTREET MANOR",
            "address_2": "440 NORTH MAIN STREET",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-825-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CAROL",
        "middle_name": "W.",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT003123L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn Jo Newhart, CRNP
• Tristan Nguyen-Luu, M.D
• Kimmy Nguyen, PHARMD
• Lucia Nguyen, DPM
• Linda Nichols
• Julie Pandora Nickles, D.O.
• Carl Nieweld, M.D.
• Shivprasad D. Nikam, M.D.
• Smita S. Nikam, M.D.
• Apoorv Amit Nimbvikar

• Physical Therapist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.