Nicholas Dellaflora
Individual provider Active NPI Physical Therapist · Russell, KY
NPI 1700568854 · NPPES record last updated Apr 18, 2025
Key facts
- NPI
- 1700568854
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 009006 (KY)
- Practice address
- 1490 Diederich Blvd
Russell, KY 41169-1719 - Phone
- (606) 833-9444
- Fax
- (606) 833-9442
- NPI assigned
- Aug 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009006 | KY | MD | Physical Therapist |
| PT020669 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Therapy & Health Centers, Inc. | Single Specialty | Past | Accepting new patients |
| Premier Therapy & Health Centers, Inc. | Past | Accepting new patients | |
| Premier Therapy & Health Centers, Inc. | Past | Accepting new patients | |
| Premier Therapy & Health Centers, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT020669 | OH | |
| Physical Therapist | 225100000X | 009006 | KY | Yes |
Addresses
Primary practice location
1490 Diederich Blvd
Russell, KY 41169-1719
Mailing address
112 Hillcrest CT
Russell, KY 41169-1401
Phone (614) 557-9340
Other practice location 1
209 N 2nd St
Ironton, OH 45638-1485
Phone (740) 534-1410
Other practice location 2
2400 13th St
Ashland, KY 41102-4510
Phone (606) 329-0910
Other providers in Russell, KY
- Community Inclusion LLC
- Community Inclusion LLC
- Community Inclusion LLC
- Lane Cullums
- Lisa Dean
- Neil Alan Evans
- Firm Foundations Salon, Inc.
- Anita Frazier-Brooks
- Michele A Friday
- Ashley Brooke Hall
All providers in Russell, KY · Physical Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.