Brian Nicholson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT12720 Issued in FL

Practice address

8100 NW 27TH Blvd Apt D116
Gainesville, FL 32606-8613

Phone

(352) 792-6464

NPI assigned

Aug 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1508477340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 SW GRANDVIEW ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256614",
            "telephone_number": "727-992-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 NW 27TH BLVD APT D116",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326068613",
            "telephone_number": "352-792-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 NW 27th Blvd Apt D116",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326068613",
            "country_code": "US",
            "telephone_number": "352-792-6464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8100 NW 27th Blvd Apt D116",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326068613",
            "country_code": "US",
            "telephone_number": "352-792-6464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Nichols
• Larissa Nichols, RN
• Ronald D Nichols
• Ronnie C Nichols
• Shamara Adranah Nichols, LCSW
• Kaitlin Nicholson
• Kelly Nicholson
• Paige Jeanette Nicholson, DMD
• Stephen Jeffrey Nickelburg
• Kelly Nicole Nickell

• Physical Therapist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.