Joseph John Nichols III, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J10000921 Issued in DE

Practice address

28535 Dupont Blvd
Unit 1
Millsboro, DE 19966-4799

Phone

(302) 297-0700

Fax

(302) 297-0701

NPI assigned

Nov 3, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

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.

• Ati Holdings, LLC

  dba ATI Physical Therapy

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  DE, Physical Therapist

  Medicare reassignment NPD
• Phoenix Rehabilitation and Health Services of Delaware Inc

  • Physical Therapist
  • Cranberry Township, PA
  • NPI 1912951021

  DE

  Medicare reassignment
• Ati Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • King of Prussia, PA
  • NPI 1750194460

  Physical Therapist

  NPD

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1376622860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28535 DUPONT BLVD",
            "address_2": "UNIT 1",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199664799",
            "telephone_number": "302-297-0700",
            "fax_number": "302-297-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_suffix": "III",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10000921",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000220726",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Mulhern, OTR/L
• Shelley Murphy, LCSW
• Kunwal Nasrullah, MD
• National Mentor Healthcare, LLC (Delaware Mentor)
• Phuong Nguyen, RPH
• Shaunta L Nichols
• Erin Nielsen, PT
• Melissa Noah, PA-C
• Sara Elizabeth Novy, DPT
• Carolyn Baier O'Conor, M.D.

• Physical Therapist in Millsboro, DE
• Providers in Millsboro, DE by specialty
• Physical Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.