NPIMap

Individual provider Active NPI

Lauren Teresa Nicholson, P.T.

  • Physical Therapist
  • Montgomery, NY
National Provider Identifier
1104971324
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023892 Issued in NY
Practice address
20 Walnut St
Suite B
Montgomery, NY 12549-2230
Phone
(845) 457-5555
Fax
(845) 457-5556
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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 023892 NY Primary

Addresses

Primary practice location

20 Walnut St
Suite B
Montgomery, NY 12549-2230

Mailing address

20 Walnut Street
Suite B
Montgomery, NY 12549
Phone (845) 457-5555

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
023892NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Physical and Occupational Therapy PLLC Physical Therapist Past Accepting new patients
Laura M. Stevens PT PC Physical Therapist Past Accepting new patients

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1104971324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WALNUT STREET",
            "address_2": "SUITE B",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "12549",
            "telephone_number": "845-457-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WALNUT ST",
            "address_2": "SUITE B",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125492230",
            "telephone_number": "845-457-5555",
            "fax_number": "845-457-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LAUREN",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.