Individual provider Active NPI

Nicholas J Rainville

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1114425550
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040653 Issued in NY
Practice address
12225 Greenville Ave Ste 600
Dallas, TX 75243
Phone
(214) 865-8120
NPI assigned
Jan 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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 040653 NY Primary

Addresses

Primary practice location

12225 Greenville Ave Ste 600
Dallas, TX 75243

Mailing address

12225 Greenville Ave Ste 600
Dallas, TX 75243

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
040653NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1114425550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 GREENVILLE AVE STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 GREENVILLE AVE STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "214-865-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINVILLE",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.