Individual provider Active NPI

Nichole Marie Stewart, PT, DPT

  • Physical Therapist
  • Loveland, CO
National Provider Identifier
1073966016
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0014099 Issued in CO
Practice address
107 W 29TH St
Suite 100
Loveland, CO 80538-2797
Phone
(970) 663-6142
Fax
(970) 635-3087
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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 0014099 CO Primary

Addresses

Primary practice location

107 W 29TH St
Suite 100
Loveland, CO 80538-2797

Mailing address

107 W 29TH St
Suite 100
Loveland, CO 80538-2797
Phone (970) 663-6142

Other identifiers 1

IdentifierTypeStateIssuer
13912307OtherCOCAQH

Other names 1

  • Nichole Marie Engelhardt Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0014099COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1073966016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382797",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 29TH ST",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805382797",
            "telephone_number": "970-663-6142",
            "fax_number": "970-635-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0014099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13912307",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "ENGELHARDT",
            "middle_name": "MARIE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.