Active NPI
Mary Nichols, PT, DPT
- Physical Therapist
- Avondale, AZ
National Provider Identifier
1598501751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-033414
- Practice address
- 10320 W McDowell Rd. BLDG I
Suite 9030-a
Avondale, AZ 85392 - Phone
- (623) 683-7664
- NPI assigned
- Jul 6, 2024
- Sex
- Female
- 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 Therapist | 225100000X | LPT-033414 | AZ | Primary |
Addresses
Primary practice location
10320 W McDowell Rd. BLDG I
Suite 9030-a
Avondale, AZ 85392
Mailing address
7641 E Sandalwood Dr
Scottsdale, AZ 85250-7734
Phone (541) 840-0153
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 |
|---|---|---|---|
| LPT-033414 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720224000000",
"number": "1598501751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7641 E SANDALWOOD DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852507734",
"telephone_number": "541-840-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10320 W MCDOWELL RD. BLDG I",
"address_2": "SUITE 9030-A",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "85392",
"telephone_number": "623-683-7664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "MARY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-06",
"last_updated": "2024-07-06",
"certification_date": "2024-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-033414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.