Individual provider Active NPI

Nicole Lindsay Viseur, DPT

  • Physical Therapist
  • Chula Vista, CA
National Provider Identifier
1508301417
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL0014380 Issued in CO
Practice address
1020 Tierra del Rey Ste A1
Chula Vista, CA 91910-7886
Phone
(619) 585-7104
Fax
(619) 585-7106
NPI assigned
Dec 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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 PTL0014380 CO Primary

Addresses

Primary practice location

1020 Tierra del Rey Ste A1
Chula Vista, CA 91910-7886

Mailing address

1582 W San Marcos Blvd Ste 105B
San Marcos, CA 92078-4081
Phone (650) 452-4110

Other practice location 1

5935 S Zang St
#9
Littleton, CO 80127-4647
Phone (303) 979-5511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216002200 CO Practitioner - Physical Therapist in Private Practice 8426331463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panther Physical Therapy, Inc.Group PAC ID 4688670326, 13 clinicians

Practice addresses (Care Compare)

5935 S Zang St
Unit 9
Littleton, CO 80127-4645
Phone (303) 979-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298385CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Panther Physical Therapy, Inc. Physical Therapist CurrentSince Jan 10, 2017 Accepting new patients
Physio Pro, Inc. Physical Therapist PastSince Jan 10, 2017 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist PastSince Aug 1, 2020 Accepting new patients

Locations

5935 S Zang St
Unit 9
Littleton, CO 80127
Phone (303) 979-5511

Organizations & group practices 3

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": "1483142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1508301417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1582 W SAN MARCOS BLVD STE 105B",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784081",
            "telephone_number": "650-452-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TIERRA DEL REY STE A1",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107886",
            "telephone_number": "619-585-7104",
            "fax_number": "619-585-7106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5935 S Zang St",
            "address_2": "#9",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801274647",
            "country_code": "US",
            "telephone_number": "303-979-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISEUR",
        "first_name": "NICOLE",
        "middle_name": "LINDSAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-31",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0014380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.