Individual provider Active NPI

Christopher J Nichols, P.T.

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1154823094
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7186 Issued in ID
Practice address
1809 N Bingham Dr
Nampa, ID 83651-1764
Phone
(208) 466-6959
Fax
(208) 465-9901
NPI assigned
Mar 7, 2018
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10636251-2401 UT
Physical Therapist 225100000X PT7186 ID Primary

Addresses

Primary practice location

1809 N Bingham Dr
Nampa, ID 83651-1764

Mailing address

1809 N Bingham Dr
Nampa, ID 83651-1764
Phone (208) 466-6959

Other practice location 1

1551 Renaissance Towne Dr Ste 350
Bountiful, UT 84010-7674
Phone (801) 295-3553

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223000124 ID Practitioner - Physical Therapist in Private Practice 8820335136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nichols Physical Therapy LLCGroup PAC ID 4082015961, 2 clinicians

Practice addresses (Care Compare)

1809 N Bingham Dr
Nampa, ID 83651-1764
Phone (208) 466-6959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7186IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nichols Physical Therapy LLC Physical Therapist CurrentSince Jun 3, 2021 Accepting new patients

Locations

1809 N Bingham Dr
Nampa, ID 83651
Phone (208) 466-6959

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1154823094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 N BINGHAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511764",
            "telephone_number": "208-466-6959",
            "fax_number": "208-465-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 N BINGHAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511764",
            "telephone_number": "208-466-6959",
            "fax_number": "208-465-9901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1551 Renaissance Towne Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Bountiful",
            "state": "UT",
            "postal_code": "840107674",
            "country_code": "US",
            "telephone_number": "801-295-3553",
            "fax_number": "801-295-3599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10636251-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT7186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.