Individual provider Active NPI

Nicholas Williamson

  • Physical Therapist
  • Cleveland, TN
National Provider Identifier
1679316244
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15684 Issued in TN
Practice address
2556 Dalton Pike SE
Cleveland, TN 37323-7157
Phone
(423) 476-4264
NPI assigned
Jun 13, 2024
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 15684 TN Primary

Addresses

Primary practice location

2556 Dalton Pike SE
Cleveland, TN 37323-7157

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 933-1260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624001003 TN Practitioner - Physical Therapist in Private Practice 3072056696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

2556 Dalton Pike SE
Cleveland, TN 37323-7157
Phone (423) 476-4264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15684TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Jun 17, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jun 17, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2556 Dalton Pike SE
Cleveland, TN 37323
Phone (423) 476-4264

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1679316244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-933-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 DALTON PIKE SE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373237157",
            "telephone_number": "423-476-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "15684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.