Jeffrey A Nicholson Jr., PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13535 Issued in AZ

Practice address

45359 W Paitilla LN
Maricopa, AZ 85139-6714

Phone

(602) 460-8116

NPI assigned

Jan 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Liberated Rehabilitation, PLLC

  • Physical Therapist
  • Maricopa, AZ
  • NPI 1306469374
  Medicare reassignment NPD Authorized official
• Figueroa Physical Therapy

  • Physical Therapist
  • Goodyear, AZ
  • NPI 1316996978
  Medicare reassignment NPD

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590364800000",
    "number": "1326555178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45359 W PAITILLA LN",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851396714",
            "telephone_number": "602-460-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45359 W PAITILLA LN",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851396714",
            "telephone_number": "602-460-8116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42105 W Cheyenne Dr",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851383356",
            "country_code": "US",
            "telephone_number": "602-460-8116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42105 W Cheyenne Dr",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851383356",
            "country_code": "US",
            "telephone_number": "602-460-8116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6213 S Miller Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "85326",
            "country_code": "US",
            "telephone_number": "623-386-2660",
            "fax_number": "623-386-3412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-02",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Horizon Therapeutic Care, LLC
• New Revive House, LLC
• Khang Nguyen Nguyen, PHARM. D.
• Tin Huu Nguyen, D.D.S.
• Nhouse Inc
• Linda Nishikawa
• NJS Home Health LLC
• Joseph Njuguna
• James Patrick Noga, MS, BCBA, LBA
• Northern Lights Therapy PLLC

• Physical Therapist in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.