Individual provider Active NPI

Nicholas Lee Hodges

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1487123071
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
139148 Issued in AK
Practice address
3051 E Palmer Wasilla Hwy
Wasilla, AK 99654-7234
Phone
(866) 239-2761
NPI assigned
Nov 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 139148 AK Primary

Addresses

Primary practice location

3051 E Palmer Wasilla Hwy
Wasilla, AK 99654-7234

Mailing address

3051 E Palmer Wasilla Hwy
Wasilla, AK 99654-7234
Phone (866) 239-2761

Other practice location 1

157 Lewis St
North Pole, AK 99705-7699
Phone (907) 488-4978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125003101 AK Practitioner - Physical Therapist in Private Practice 7214274448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Physical Therapy TX LLC Physical Therapist CurrentSince Sep 28, 2024 Accepting new patients
Advanced Physical Therapy Inc Physical Therapist CurrentSince Aug 2, 2022 Accepting new patients

Locations

1917 Abbott Rd
Ste 200
Anchorage, AK 99507
Phone (907) 279-4266

3051 E Palmer Wasilla Hwy
Wasilla, AK 99654
Phone (907) 352-4800

24014 W Renwick Rd
Ste 206
Plainfield, IL 60544

5718 Spohn Dr
Ste 200
Corpus Christi, TX 78414
Phone (361) 906-2062

2720 Western Center Blvd
Ste 312
Fort Worth, TX 76131
Phone (817) 847-0200

8150 Highway 26
North Richlnd Hls, TX 76180
Phone (817) 349-2777

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1487123071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 E PALMER WASILLA HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547234",
            "telephone_number": "866-239-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 E PALMER WASILLA HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547234",
            "telephone_number": "866-239-2761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Lewis St",
            "address_purpose": "LOCATION",
            "city": "North Pole",
            "state": "AK",
            "postal_code": "997057699",
            "country_code": "US",
            "telephone_number": "907-488-4978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "NICHOLAS",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "139148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.