Individual provider Active NPI

Nicole Zeller

  • Physical Therapist
  • Bala Cynwyd, PA
National Provider Identifier
1386042588
Registry record updated Dec 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT023342 Issued in PA
Practice address
150 Monument Rd
Suite 300
Bala Cynwyd, PA 19004-1702
Phone
(800) 789-7336
NPI assigned
Dec 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT023342 PA Primary
Physical Therapist 225100000X 40QA01412000 NJ

Addresses

Primary practice location

150 Monument Rd
Suite 300
Bala Cynwyd, PA 19004-1702

Mailing address

1520 Federal St
Philadelphia, PA 19146-3125

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

LicenseStateTypeSpecialty
40QA01412000NJMDPhysical Therapist
PT023342PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1419120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419120000000",
    "number": "1386042588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 FEDERAL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "SUITE 300",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "800-789-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-21",
        "last_updated": "2014-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023342",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01412000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2014; 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.