Niccia McClure, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH#5070 Issued in AL

Practice address

40 Wisteria PL
Millbrook, AL 36054-1866

Phone

(334) 285-0239

Fax

(334) 285-9689

NPI assigned

May 23, 2007

Last updated

Oct 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Body Logic Physical Therapy LLC

  • Physical Therapist
  • Montgomery, AL
  • NPI 1366851966
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1215147624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WISTERIA PL",
            "city": "MILLBROOK",
            "state": "AL",
            "postal_code": "360541866",
            "telephone_number": "334-285-0239",
            "fax_number": "334-285-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WISTERIA PL",
            "city": "MILLBROOK",
            "state": "AL",
            "postal_code": "360541866",
            "telephone_number": "334-285-0239",
            "fax_number": "334-285-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "NICCIA",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH#5070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla H Wohlman MD PC
• Guy Wayne Martin, BC-HIS
• Timothy Pierre Martin, ED.S, LPC, NCC
• Kimberly McCants
• Michelle Keener McClanahan, PHARMD
• Rayna Iman Means, DMD
• Stallard Delmus Mikell Jr., RPH
• Millbrook Eye Care LLC (River Region Vision Source)
• Millbrook Family Chiropractic LLC
• Millbrook Family Healthcare

• Physical Therapist in Millbrook, AL
• Providers in Millbrook, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.