Betty H Nicodemus, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH3235 Issued in AL

Practice address

245 Cahaba Valley Pkwy
Pelham, AL 35124-2216

Phone

(205) 942-6820

Fax

(205) 942-5627

NPI assigned

Feb 22, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295860922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MORGAN AVE SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350554616",
            "telephone_number": "256-775-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242216",
            "telephone_number": "205-942-6820",
            "fax_number": "205-942-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "BETTY",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-36221",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Nevels
• Jordan Nguyen
• Mia Phi Nguyen
• Sarah Jessica Nguyen, OTD, OTR/L
• Natalie Marie Nichols, OTR/L
• Robert Bradley Nipper, PHARMD
• Nna of Alabama, Inc.
• Ron Dean Nolan, P.T.
• Linda Noland, SLP
• Elizabeth S Norberg

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.