Organization Active NPI

Nichols Physical Therapy LLC

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1679148993
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NICHOLS PHYSICAL THERAPY LLC
Practice address
1809 N Bingham Dr
Nampa, ID 83651-1764
Phone
(208) 466-6959
Fax
(208) 465-9901
NPI assigned
May 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christopher Nichols, DPTNPI 1154823094
Title
Owner/Physical Therapist
Phone
(208) 466-6959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1809 N Bingham Dr
Nampa, ID 83651-1764

Mailing address

1809 N Bingham Dr
Nampa, ID 83651-1764
Phone (208) 466-6959

Other names 1

  • MORRIS PHYSICAL THERAPY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210629003300 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082015961 Receives reassigned benefits from 2 practitioners
Practice locations: Nampa, ID

National Provider Directory

National Provider Directory

Locations

1809 N Bingham Dr
Nampa, ID 83651
Phone (208) 466-6959

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1679148993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 N BINGHAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511764",
            "telephone_number": "208-466-6959",
            "fax_number": "208-465-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 N BINGHAM DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511764",
            "telephone_number": "208-466-6959",
            "fax_number": "208-465-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-466-6959",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MORRIS PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.