Individual provider Active NPI

Timothy Wyckoff Nix, PT

  • Physical Therapist
  • Union, NH
National Provider Identifier
1467764670
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7141 Issued in ME
Practice address
24 Main St Unit 2
Union, NH 03887-4420
Phone
(603) 522-7387
NPI assigned
Jul 6, 2010
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003198 WV
Physical Therapist 225100000X 230520576 VA
Physical Therapist 225100000X PT005628 KY
Physical Therapist 225100000X PT.012959 OH
Physical Therapist 225100000X PT5578 NM
Physical Therapist 225100000X PT7141 ME Primary

Addresses

Primary practice location

24 Main St Unit 2
Union, NH 03887-4420

Mailing address

13 Eaton Rd
Brookfield, NH 03872-7341
Phone (304) 417-2991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250625000728 ME Practitioner - Physical Therapist in Private Practice 7810116514 Reassigns benefits to 1 organization
I20250723000706 NH Practitioner - Physical Therapist in Private Practice 7810116514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, shared by 4 NPIs, 137 clinicians

Practice addresses (Care Compare)

24 Main St
Unit 2
Union, NH 03887-4463
Phone (603) 522-7387

400 N St
Suite 2
Saco, ME 04072-1867
Phone (207) 282-7121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT005628KYMDPhysical Therapist
PT7141MEMDPhysical Therapist
PT5578NMMDPhysical Therapist
PT.012959OHMDPhysical Therapist
230520576VAMDPhysical Therapist
PT003198WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist CurrentSince Jun 16, 2025 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Jun 16, 2025 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Jun 23, 2025 Accepting new patients
St. Mary's Himg, LLC Past Accepting new patients

Locations

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

75 Newport Rd
Unit 4
New London, NH 03257
Phone (603) 526-2781

24 Main St
Unit 2
Union, NH 03887
Phone (603) 522-7387

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1467764670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 EATON RD",
            "city": "BROOKFIELD",
            "state": "NH",
            "postal_code": "038727341",
            "telephone_number": "304-417-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAIN ST UNIT 2",
            "city": "UNION",
            "state": "NH",
            "postal_code": "038874420",
            "telephone_number": "603-522-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "TIMOTHY",
        "middle_name": "WYCKOFF",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT003198",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "230520576",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT005628",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.012959",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5578",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.