Lyndsey Brooke Nichols, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT015544 Issued in GA

Practice address

500 Spring St SE Ste 101
Gainesville, GA 30501-3773

Phone

(770) 615-7676

NPI assigned

Aug 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifting Spirits Therapy Services, Inc

  • Pediatric Occupational Therapist
  • Gainesville, GA
  • NPI 1083891907

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1588330575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SPRING ST SE STE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013773",
            "telephone_number": "770-615-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SPRING ST SE STE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013773",
            "telephone_number": "770-615-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "LYNDSEY",
        "middle_name": "BROOKE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT015544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841619876",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ClinicSource",
            "affiliation": "N",
            "endpointDescription": "Hippa Compliant EMR system",
            "address_1": "500 Spring St SE Ste 101",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tuyet Thi Nguyen, AGACNP
• Vy Thi Tuong Nguyen, PHARMD
• Daisy Abela Ngwainmbi, M.D.
• Angel Nichols, PA
• Erin Kathleen Nichols, M.ED. CCC-SLP
• Heidi T Nicholson, MD
• Richard Douglas Nickels, DDS
• Jason Jamesryan Rutland Nierenhausen, ATC
• Derek Nathaniel Nikolaus
• Joy Nish Nix, DO

• Pediatric Physical Therapist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.