Individual provider Active NPI

Nicole Abigail Durgan

  • Physical Therapist
  • Peabody, MA
National Provider Identifier
1174773105
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16063 Issued in MA
Practice address
1 Orthopedics Dr
Peabody, MA 01960-1668
Phone
(978) 818-6260
NPI assigned
Sep 26, 2008
Last updated
Sep 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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 16063 MA Primary

Addresses

Primary practice location

1 Orthopedics Dr
Peabody, MA 01960-1668

Mailing address

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131125000389 MA Practitioner - Physical Therapist in Private Practice 8729214606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

2 1St Ave
Suite 211
Peabody, MA 01960-4962
Phone (978) 818-6350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine North Orthopaedic Surgery, Inc Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients
Sports Medicine North Orthopaedic Surgery, Inc. Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients

Locations

1 Orthopedics Dr
Peabody, MA 01960
Phone (781) 595-4562

1 Orthopedics Dr
Ste 2
Peabody, MA 01960
Phone (978) 818-6493

Interoperability endpoints

  • Direct secure messaging: nicole.durgan.1@7605.direct.athenahealth.com

Organizations & group practices 2

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": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1174773105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURGAN",
        "first_name": "NICOLE",
        "middle_name": "ABIGAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.