Theresa Nicholson, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT015743 Issued in GA

Practice address

2107 N Decatur Rd Unit 506
Decatur, GA 30033-5305

Phone

(470) 831-4049

Fax

(770) 626-0089

NPI assigned

Jan 24, 2022

Last updated

May 28, 2025By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kennestone Hospital, Inc

  dba Wellstar Kennestone Hospital Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Atlanta, GA
  • NPI 1689361438
  NPD (past)
• Rand Speech Pathology LLC

  dba Rand Speech Pathology

  • Behavior Analyst
  • Decatur, GA
  • NPI 1659440329
  NPD (past)

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1336891183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 N DECATUR RD UNIT 506",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335305",
            "telephone_number": "470-831-4049",
            "fax_number": "770-626-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 N DECATUR RD UNIT 506",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335305",
            "telephone_number": "470-831-4049",
            "fax_number": "770-626-0089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Highway 54 W Ste 404",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144564",
            "country_code": "US",
            "telephone_number": "470-615-0485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "THERESA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT015743",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT015743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tam Nguyen
• Thu Thao Nguyen, PHARMD
• Vian Kim Nguyen, PHARMD, BCPS
• Abdul Niazi, NP
• Tanya Nicholas
• Yanire Nieves, M.D., MBA
• Venise Niles
• Kristian Peter Nitsch, PHD
• Jessica Nix
• Edwin N Njenga, NP

• Pediatric Physical Therapist in Decatur, GA
• Providers in Decatur, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.