NPIMap

Individual provider Active NPI

Nick Fox

  • Skilled Nursing Facility
  • Painesville, OH
National Provider Identifier
1669921896
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PT016532 Issued in OH
Practice address
164 Liberty St
Painesville, OH 44077-3331
Phone
(440) 357-6181
NPI assigned
Sep 29, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 26

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.

View all 26

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLC (399 clinicians)

Practice addresses (Care Compare)

501 Chardon Windsor Rd
Chardon, OH 44024-8944
Phone (800) 444-6845

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241014004668 OH Practitioner - Physical Therapist in Private Practice 6709318801 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT016532OHMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Current
since Aug 20, 2024		 Accepting new patients
Aegis Group Practice LLC Current Accepting new patients
Aegis Group Practice LLC Current
since Aug 20, 2024		 Accepting new patients

Locations

501 Chardon Windsor Rd
Chardon, OH 44024
Phone (440) 286-2277

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X PT016532 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

164 Liberty St
Painesville, OH 44077-3331

Mailing address

18473 Mumford Rd
Garrettsville, OH 44231-9505
Phone (440) 488-3771

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 29, 2016.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1669921896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18473 MUMFORD RD",
            "city": "GARRETTSVILLE",
            "state": "OH",
            "postal_code": "442319505",
            "telephone_number": "440-488-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 LIBERTY ST",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440773331",
            "telephone_number": "440-357-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "NICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "PT016532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.