Active NPI
Nicole McCutchan
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1326348145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A3090
- Practice address
- 2425 S 171St St
Omaha, NE 68130-2393 - Phone
- (180) 045-6585
- NPI assigned
- Oct 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A3090 | MD | Primary |
Addresses
Primary practice location
2425 S 171St St
Omaha, NE 68130-2393
Mailing address
HC 69 Box 3
West Union, WV 26456-8901
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A3090 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1326348145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 69 BOX 3",
"city": "WEST UNION",
"state": "WV",
"postal_code": "264568901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 S 171ST ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681302393",
"telephone_number": "180-045-6585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCUTCHAN",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-26",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A3090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.