Individual provider Active NPI

Rachel Nickell, OT

  • Occupational Therapist
  • San Tan Valley, AZ
National Provider Identifier
1508722620
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-010406 Issued in AZ
Practice address
40601 N Gantzel Rd Ste 103
San Tan Valley, AZ 85140-7036
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Jan 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OTH-010406 AZ
Occupational Therapist 225X00000X OTH-010406 AZ Primary

Addresses

Primary practice location

40601 N Gantzel Rd Ste 103
San Tan Valley, AZ 85140-7036

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other practice location 1

2940 E Banner Gateway Dr Ste 200-250
Gilbert, AZ 85234-2168
Phone (602) 648-5444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116000632 CO Practitioner - Occupational Therapist in Private Practice 5991282337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Potential RLLPGroup PAC ID 7719976703, 20 clinicians

Practice addresses (Care Compare)

1612 E Pikes Peak Ave
Colorado Springs, CO 80909-5619
Phone (719) 630-3193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH-AZMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Potential RLLP CurrentSince Jan 12, 2026 Accepting new patients
Action Potential RLLP CurrentSince Jan 12, 2026 Accepting new patients

Locations

2955 Professional Pl
Ste 200
Colorado Springs, CO 80904
Phone (719) 227-7079

1612 E Pikes Peak Ave
Colorado Springs, CO 80909
Phone (719) 475-8080

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": "1767312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1508722620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40601 N GANTZEL RD STE 103",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407036",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 E Banner Gateway Dr Ste 200-250",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342168",
            "country_code": "US",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "RACHEL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-02",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "AZ",
            "license": "OTH-010406",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-010406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.