Individual provider Active NPI

Nicole Lynn Thaxton, PT

  • Physical Therapist
  • Irving, TX
National Provider Identifier
1073034252
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1290816 Issued in TX
Practice address
701 Tuscan Dr
Irving, TX 75039-4133
Phone
(214) 727-8820
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1290816 TX Primary

Addresses

Primary practice location

701 Tuscan Dr
Irving, TX 75039-4133

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other names 1

  • Nicole Faldyn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926003823 TX Practitioner - Physical Therapist in Private Practice 1850665084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

4843 Colleyville Blvd
Suite 221
Colleyville, TX 76034-3986
Phone (817) 576-7520

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 5, 2017 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 5, 2017 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

5335 W Sublett Rd
Ste 151
Arlington, TX 76017
Phone (817) 839-9150

3000 FM 407 E
Ste 500
Bartonville, TX 76226
Phone (940) 448-2007

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

4843 Colleyville Blvd
Ste 221
Colleyville, TX 76034
Phone (817) 576-7520

106 N Denton Tap Rd
Ste 220
Coppell, TX 75019
Phone (469) 528-6437

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

2360 W Camp Wisdom Rd
Ste 140
Grand Prairie, TX 75052
Phone (469) 460-6683

1401 William D Tate Ave
Ste 300
Grapevine, TX 76051
Phone (817) 527-3377

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

861 North Tarrant Pkwy
Unit 100
Keller, TX 76248
Phone (817) 918-2480

5121 Rufe Snow Dr
Ste 110
North Richland Hills, TX 76180
Phone (817) 345-4367

245 W State Highway 114
Ste 320
Southlake, TX 76092
Phone (817) 873-5311

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1073034252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 TUSCAN DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394133",
            "telephone_number": "214-727-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAXTON",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1290816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "FALDYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.