Individual provider Active NPI

Daisy Nicholas

  • Physical Therapist
  • Madison Heights, MI
National Provider Identifier
1568831949
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014577 Issued in MI
Practice address
30551 Stephenson Hwy Ste B
Madison Heights, MI 48071
Phone
(248) 556-5008
Fax
(248) 951-8924
NPI assigned
Sep 16, 2015
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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 5501014577 MI Primary

Addresses

Primary practice location

30551 Stephenson Hwy Ste B
Madison Heights, MI 48071

Mailing address

2605 Golfview Dr Apt 104
Troy, MI 48084-3801
Phone (586) 822-0798

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medshop Pharmacy LLC CurrentSince May 5, 2017 Accepting new patients
Stopin Pharmacy LLC PastSince Jun 1, 2020 Accepting new patients

Locations

30551 Stephenson Hwy
Ste B
Madison Heights, MI 48071
Phone (248) 556-5008

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, 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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1568831949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 GOLFVIEW DR APT 104",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843801",
            "telephone_number": "586-822-0798",
            "fax_number": "248-823-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30551 STEPHENSON HWY STE B",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-556-5008",
            "fax_number": "248-951-8924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "DAISY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.