Active NPI
Stephen Grant Nichols, MPT
- Physical Therapist
- Taylorsville, MS
National Provider Identifier
1689705253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3150
- Practice address
- 140 Eureka Street
Taylorsville, MS 39168 - Phone
- (601) 785-9292
- NPI assigned
- Mar 8, 2007
- 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 | PT3150 | MS | Primary |
Addresses
Primary practice location
140 Eureka Street
Taylorsville, MS 39168
Mailing address
641 Hoy Rd
Laurel, MS 39443-0912
Phone (601) 433-5926
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 |
|---|---|---|---|
| PT3150 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689705253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "641 HOY RD",
"city": "LAUREL",
"state": "MS",
"postal_code": "394430912",
"telephone_number": "601-433-5926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 EUREKA STREET",
"city": "TAYLORSVILLE",
"state": "MS",
"postal_code": "39168",
"telephone_number": "601-785-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "STEPHEN",
"middle_name": "GRANT",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT3150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.