Active NPI
Paul Nichols
- Physical Therapist
- Liberty TWP, OH
National Provider Identifier
1659502805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 006291
- Practice address
- 5644 Quapaw CT
Liberty TWP, OH 45011-8470 - Phone
- (513) 759-6116
- NPI assigned
- Aug 6, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 | PT 006291 | OH | Primary |
Addresses
Primary practice location
5644 Quapaw CT
Liberty TWP, OH 45011-8470
Mailing address
5644 Quapaw CT
Liberty TWP, OH 45011-8470
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 |
|---|---|---|---|
| PT 006291 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1659502805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5644 QUAPAW CT",
"city": "LIBERTY TWP",
"state": "OH",
"postal_code": "450118470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5644 QUAPAW CT",
"city": "LIBERTY TWP",
"state": "OH",
"postal_code": "450118470",
"telephone_number": "513-759-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-06",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT 006291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty TWP, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.