Theresa Louise Nichols, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000005516 Issued in TN

Practice address

1030 Jefferson Ave
Memphis, TN 38104-2127

Phone

(901) 523-8990

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Theresa Louise Maddox-Allen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ave Maria Home

  • Nursing Facility/Intermediate Care Facility
  • Memphis, TN
  • NPI 1831250604

  Physical Therapist

  NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Clinton, TN
  • NPI 1376073262
  NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1144368630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7078 OAK ACRES LN",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381351877",
            "telephone_number": "901-870-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "THERESA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000005516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MADDOX-ALLEN",
            "middle_name": "LOUISE",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Delania Diane Nichols, RN
• Emma Nichols
• Joanna Marie Nichols, LICENSED NURSE
• Kim E Nichols, M.D.
• Rachael Nichols, COTA/L
• Tiffany Nichols
• Katie Nicholson, APRN
• Christopher M Nickele, M.D.
• Eugenie B Nickell, LPC
• Zakiya Oni Nicks, OD

• Physical Therapist in Memphis, TN
• Providers in Memphis, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.