Individual provider Active NPI

Nichole Marie Harold, PT

  • Physical Therapist
  • Palmetto, FL
National Provider Identifier
1124031703
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9488 Issued in FL
Practice address
5108 Beacon Rd
Palmetto, FL 34221-8764
Phone
(941) 758-2111
Fax
(941) 758-2082
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 PT9488 FL Primary

Addresses

Primary practice location

5108 Beacon Rd
Palmetto, FL 34221-8764

Mailing address

PO Box 39
Terra Ceia, FL 34250-0039
Phone (941) 758-2111

Other names 1

  • Nichole Marie Gorski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000370 FL Practitioner - Physical Therapist in Private Practice 5193764082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5108 Beacon Rd
Palmetto, FL 34221-8764
Phone (941) 758-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9488FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body in Balance, Inc. Physical Therapist CurrentSince Sep 11, 2003 Accepting new patients

Locations

701 Manatee Ave W
Ste 103
Bradenton, FL 34205
Phone (941) 264-1414

4442 5th St W
Bradenton, FL 34207
Phone (941) 744-1211

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1124031703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "TERRA CEIA",
            "state": "FL",
            "postal_code": "342500039",
            "telephone_number": "941-758-2111",
            "fax_number": "941-758-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 BEACON RD",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342218764",
            "telephone_number": "941-758-2111",
            "fax_number": "941-758-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROLD",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT9488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "GORSKI",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmetto, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.