Nicole J Sweazy, P. T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070012965 Issued in IL

Practice address

209 N Cummings LN
Washington, IL 61571-2181

Phone

(309) 886-2305

Fax

(309) 444-3893

NPI assigned

Jan 16, 2007

Last updated

Oct 27, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1487705539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-886-2305",
            "fax_number": "309-444-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-886-2305",
            "fax_number": "309-444-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEAZY",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "P. T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP MEMBER PTAN",
            "identifier": "P00751932",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11581915",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Washington, IL
• Providers in Washington, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.