Nicole Seal

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

65084 Issued in OR

Practice address

1470 NE 3Rd St
Prineville, OR 97754-2906

Phone

(541) 447-6846

Fax

(541) 447-1243

NPI assigned

Aug 30, 2023

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

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• New Proactive LLC

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Omnis Omnia Inc.

  • Orthopedic Physical Therapist
  • Redmond, OR
  • NPI 1013949239
  NPD (past)

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1073398749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "334-231-5364",
            "fax_number": "334-513-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 NE 3RD ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977542906",
            "telephone_number": "541-447-6846",
            "fax_number": "541-447-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAL",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Sandoval
• Geoffrey Michael Saunders, PHARMD
• Charissa Schmidt
• Adriaa L Schmitt, LMT
• Shana L Schmitz, MA, LPC
• Jacqueline Sharib, LCSW
• Hugh Thomas Shepard, QMHA
• Patricia Short, LPC
• Ryan Short, DPT
• Kayle Ryn Shrauger

• Physical Therapist in Prineville, OR
• Providers in Prineville, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.