Active NPI
Nicolas Alan Riggs
- Physical Therapy Assistant
- Green Bay, WI
National Provider Identifier
1679904684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2030-19
- Practice address
- 2869 Viking Dr
#165
Green Bay, WI 54304-5990 - Phone
- (414) 615-0665
- Fax
- (414) 615-0667
- NPI assigned
- Dec 2, 2013
- Sex
- Male
- 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 | 2030-19 | WI | Primary |
Addresses
Primary practice location
2869 Viking Dr
#165
Green Bay, WI 54304-5990
Mailing address
2869 Viking Dr
#165
Green Bay, WI 54304-5990
Phone (414) 615-0665
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 |
|---|---|---|---|
| 2030-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RG-Rhinelander, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Skilled Nursing Facility
- Rhinelander, WI
- NPI 1407164312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1679904684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2869 VIKING DR",
"address_2": "#165",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045990",
"telephone_number": "414-615-0665",
"fax_number": "414-615-0667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2869 VIKING DR",
"address_2": "#165",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045990",
"telephone_number": "414-615-0665",
"fax_number": "414-615-0667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIGGS",
"first_name": "NICOLAS",
"middle_name": "ALAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-02",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2030-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.