Nicole Schaefer, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502003179 Issued in MI

Practice address

709 W Superior St
Wayland, MI 49348-1226

Phone

(269) 792-4440

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Huisken Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)
• Northern Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Lyndonville, VT
  • NPI 1164509980
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1295186336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W SUPERIOR ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W SUPERIOR ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481226",
            "telephone_number": "269-792-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN PTA LICENSE",
            "identifier": "5502003179",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HUISKEN",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Michael Rowe, RPH
• Donna Jacobs Rozema, COTA
• Melissa Russo
• Samuel Huizenga Nutrition LLC
• Samantha Samuels
• Schug Counseling Services, PLLC
• Christina Margaret Schug, LMSW
• Kayla Marie Schulz, PT, DPT, CLT
• Robert Schutt
• Sensory Systems Clinic West

• Physical Therapy Assistant in Wayland, MI
• Providers in Wayland, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.