Michael Niebergall

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P1 60231813 Issued in WA

Practice address

1301 N Highlands Pkwy
Tacoma, WA 98406-2116

Phone

(253) 752-7112

NPI assigned

Jan 24, 2014

Last updated

Jan 24, 2014By the provider in NPPES

Sex

Male

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": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1083037287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 84TH AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984671824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N HIGHLANDS PKWY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062116",
            "telephone_number": "253-752-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBERGALL",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60231813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dystiny D Nickle
• Desirae Layne Nicks, CG60864058
• Rodney Nicolas, PHARM.D.
• Nicole M. Ancich, DMD PLLC
• Alex Nicoud
• Katie Jean Niehl, AU.D.
• Amy M Nielsen, CRNA
• Jamison Scott Nielsen, D.O.
• Kathleen Michelle Nielsen, MSW
• Sean T Nielson, PA-C, MPAS

• Physical Therapy Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.