Active NPI
Olivia Nicholls, DPT
- Physical Therapist
- Elma, WA
National Provider Identifier
1154055770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61267761
- Practice address
- 600 E Main St
Elma, WA 98541-9560 - Phone
- (360) 346-2298
- Fax
- (360) 346-2179
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61267761 | WA | Primary |
Addresses
Primary practice location
600 E Main St
Elma, WA 98541-9560
Mailing address
11808 Grant St FL 100
Omaha, NE 68164-3616
Phone (877) 230-3885
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61267761 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1154055770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11808 GRANT ST FL 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681643616",
"telephone_number": "877-230-3885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E MAIN ST",
"city": "ELMA",
"state": "WA",
"postal_code": "985419560",
"telephone_number": "360-346-2298",
"fax_number": "360-346-2179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLLS",
"first_name": "OLIVIA",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "61267761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.