Active NPI
Nicole Stockwell, L.M.T.
- Massage Therapist
- Burrillville, RI
National Provider Identifier
1487955803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT00609
- Practice address
- 1452 Broncos Hwy
Suite 3
Burrillville, RI 02830-1660 - Phone
- (401) 371-2890
- Fax
- (401) 371-2892
- NPI assigned
- Nov 17, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT00609 | RI | Primary |
Addresses
Primary practice location
1452 Broncos Hwy
Suite 3
Burrillville, RI 02830-1660
Mailing address
500 Reservoir Rd
Pascoag, RI 02859-3532
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT00609 | RI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Body Physical Therapy, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Oakland, RI
- NPI 1184958548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289952000000",
"number": "1487955803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 RESERVOIR RD",
"city": "PASCOAG",
"state": "RI",
"postal_code": "028593532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1452 BRONCOS HWY",
"address_2": "SUITE 3",
"city": "BURRILLVILLE",
"state": "RI",
"postal_code": "028301660",
"telephone_number": "401-371-2890",
"fax_number": "401-371-2892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCKWELL",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "L.M.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-17",
"last_updated": "2010-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "RI",
"license": "MT00609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burrillville, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.