Individual provider Active NPI

Doris C. Nichols, P.T. , M.A.

  • Physical Therapist
  • Simpsonville, SC
National Provider Identifier
1265539183
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
117 Issued in SC
Practice address
719 SE Main St
Ssi Physical Therapy
Simpsonville, SC 29681-3237
Phone
(864) 963-9229
NPI assigned
Sep 20, 2006
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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 117 SC Primary

Addresses

Primary practice location

719 SE Main St
Ssi Physical Therapy
Simpsonville, SC 29681-3237

Mailing address

696 Stoddard Mill Rd
Gray Court, SC 29645-3832
Phone (864) 862-3700

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
117SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Integrated Therapy Centers, LLC Physical Therapist PastSince Nov 1, 2021 Accepting new patients
Sports Spine & Industrial, Inc. Physical Therapist PastSince Jun 3, 2002 Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1265539183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 STODDARD MILL RD",
            "city": "GRAY COURT",
            "state": "SC",
            "postal_code": "296453832",
            "telephone_number": "864-862-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 SE MAIN ST",
            "address_2": "SSI PHYSICAL THERAPY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813237",
            "telephone_number": "864-963-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "DORIS",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "P.T. , M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.