Individual provider Active NPI

Nicole J Chine, PT

  • Physical Therapist
  • Grand Forks AFB, ND
National Provider Identifier
1548370752
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1317 Issued in ND
Practice address
1599 J St
Grand Forks AFB, ND 58205-6306
Phone
(701) 747-5555
NPI assigned
Aug 30, 2006
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 1317 ND Primary

Addresses

Primary practice location

1599 J St
Grand Forks AFB, ND 58205-6306

Mailing address

1599 J St
Grand Forks AFB, ND 58205-6306
Phone (701) 747-5555

Other identifiers 6

IdentifierTypeStateIssuer
B17461047855OtherPREFERRED ONE
51268MedicaidND
64-06759OtherMEDICA
253467000MedicaidMN
79G99CHOtherBLUE CROSS/BLUE SHIELD MN
27383OtherBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061010000502 ND Practitioner - Physical Therapist in Private Practice 2860498177 Reassigns benefits to 1 organization
I20240711001667 MN Practitioner - Physical Therapist in Private Practice 2860498177 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Therapy LLC Physical Therapist CurrentSince May 8, 2024 Accepting new patients
Achieve Therapy LLC Physical Therapist CurrentSince Jul 23, 2007 Accepting new patients
Achieve Therapy LLC Physical Therapist CurrentSince Jul 23, 2007 Accepting new patients
Achieve Therapy LLC Physical Therapist Current Accepting new patients

Locations

1421 Central Ave NW
East Grand Forks, MN 56721
Phone (218) 773-3010

110 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 237-3052

1425 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 746-8374

3035 Demers Ave
Grand Forks, ND 58201
Phone (701) 746-6694

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1548370752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINE",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "B17461047855",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51268",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "64-06759",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253467000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD MN",
            "identifier": "79G99CH",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "27383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks AFB, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.