Active NPI
Jessica Nicoll, PTA
- Physical Therapy Assistant
- Plains, PA
National Provider Identifier
1649656109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TEI003595
- Practice address
- 220 S River St
Plains, PA 18705-1137 - Phone
- (620) 755-2946
- NPI assigned
- Aug 7, 2015
- 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 Therapy Assistant | 225200000X | TEI003595 | PA | Primary |
Addresses
Primary practice location
220 S River St
Plains, PA 18705-1137
Mailing address
PO Box 1111
Gouldsboro, PA 18424
Phone (620) 755-2946
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 |
|---|---|---|---|
| TEI003595 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438905600000",
"number": "1649656109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1111",
"city": "GOULDSBORO",
"state": "PA",
"postal_code": "18424",
"telephone_number": "620-755-2946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 S RIVER ST",
"city": "PLAINS",
"state": "PA",
"postal_code": "187051137",
"telephone_number": "620-755-2946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLL",
"first_name": "JESSICA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-07",
"last_updated": "2015-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TEI003595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plains, PA
- Gary Paul Neale, MB CHB
- Nepa Family Practice PLLC
- Nepa Support Solutions, Inc.
- Newhart Chiropractic Center
- Joseph D Newton-Pretko, DPT
- NLS ABA Services LLC
- Northeast Pedorthic Services Inc
- Northeast Regional Anesthesia LLC
- Northeast Regional Surgery Center LLC
- Northeastern Pennsylvania Cardiology Associates LLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.