Nicole Marie McDaniel, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

5138 Issued in OR

Practice address

530 NW 23Rd Ave
Suite #116
Portland, OR 97210-3275

Phone

(971) 258-0995

Fax

(844) 364-4344

NPI assigned

Jul 26, 2005

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

Other identifiers 2

Other names 1

• Nicki McDaniel Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oregon Luna Care Physical Therapy LLCGroup PAC ID 5597178087, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Oregon Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hillsboro, OR
  • NPI 1891397121
  Medicare reassignment Care Compare group
• Body Mechanix

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1417319781
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1104826601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NW 23RD AVE",
            "address_2": "SUITE #116",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103287",
            "telephone_number": "971-258-0995",
            "fax_number": "844-364-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 23RD AVE",
            "address_2": "SUITE #116",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103275",
            "telephone_number": "971-258-0995",
            "fax_number": "844-364-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "5138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17657385",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NM REG & LICENS.",
            "identifier": "2914",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICKI",
            "last_name": "MCDANIEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia McCusker
• Kalli Sol McDade
• Jeffrey Scott McDaniel, CADC I
• Maximilian M McDaniel, MA, QMHP
• Morgan McDaniel, PT
• Philip L McDaniel, M.D.
• Richelle Nicole McDaniel, RN
• Trina McDaniel, LMT
• Charles Malcolm McDannald III, CRNA
• Joshua McDannell, CADC-R

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.