Nicole Newberry, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9808065-2401 Issued in UT

Practice address

1430 E 4500 S
Salt Lake City, UT 84117-4208

Phone

(801) 308-8198

NPI assigned

Jun 30, 2016

Last updated

Jun 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Bohn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1417308420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 E 4500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174208",
            "telephone_number": "801-308-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 E 4500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174208",
            "telephone_number": "801-308-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "9808065-2401",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2014026904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BOHN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• New Life Centers
• New Life Centers, LLC
• New Paradigm Physical Therapy (Julie Waldo)
• Kimberly Redd New
• Cynthia McCarty Newberry, M.D.
• Patti Newbold
• Tamara Marie Newbold
• Joshua Newbury, CSW, MSW
• Cynthia Ann Newby, APRN-C
• Maureen Newell

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.