Individual provider Active NPI

Angela Nichols, PTA

  • Physical Therapy Assistant
  • Thomson, GA
National Provider Identifier
1427468685
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA000561 Issued in GA
Practice address
1043 Washington Rd
Thomson, GA 30824-7318
Phone
(706) 597-1190
Fax
(706) 597-1191
NPI assigned
Apr 28, 2014
Last updated
Apr 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA000561 GA Primary

Addresses

Primary practice location

1043 Washington Rd
Thomson, GA 30824-7318

Mailing address

1156 County Line Rd
Harlem, GA 30814-3805
Phone (706) 597-1190

Other names 1

  • Miss Angela Veatch Former name

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
PTA000561GAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1427468685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 COUNTY LINE RD",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308143805",
            "telephone_number": "706-597-1190",
            "fax_number": "706-597-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 WASHINGTON RD",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308247318",
            "telephone_number": "706-597-1190",
            "fax_number": "706-597-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA000561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "VEATCH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thomson, GA

Sources for this page

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