Active NPI
Joshua Nickles
- Physical Therapy Assistant
- Elizabethton, TN
National Provider Identifier
1588499412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8057
- Practice address
- 1666 Hillview Dr
Elizabethton, TN 37643-4116 - Phone
- (423) 542-5061
- NPI assigned
- Sep 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8057 | TN | Primary |
Addresses
Primary practice location
1666 Hillview Dr
Elizabethton, TN 37643-4116
Mailing address
109 E Holston Ave
Johnson City, TN 37601-4610
Phone (423) 943-4391
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8057 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1588499412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E HOLSTON AVE",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376014610",
"telephone_number": "423-943-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1666 HILLVIEW DR",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376434116",
"telephone_number": "423-542-5061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKLES",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-02",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "8057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethton, TN
- Erin Neuberger, PHARM. D.
- New Horizons Continence Management LLC
- Tedi Denee Newman, LPC
- Jill Lyn Newton, PMHNP-BC
- Deette Kay Nicholson, CNM
- Randall Nickles
- Northeast Tennessee Medical Associates PLC
- Ocoee Hermitage Health Center LLC (Hermitage Health Center)
- Ocoee Hillview Health Center LLC (Hilllview Health Center)
- Linda Sue Oliver, LPN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.