Stefanie Bernadette Nickel, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT871471 Issued in DC

Practice address

1026 Cromwell Bridge Rd
Baltimore, MD 21286-3318

Phone

(410) 583-1515

NPI assigned

Aug 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Star Specialized Therapies and Rehabilitation, LLC

  • Early Intervention Provider Agency
  • Arlington, VA
  • NPI 1184135212
  NPD (past)

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1720244510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 S WAKEFIELD ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222041453",
            "telephone_number": "404-895-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 CROMWELL BRIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212863318",
            "telephone_number": "410-583-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "STEFANIE",
        "middle_name": "BERNADETTE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26167",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009419",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Nicholson
• Ryan Nicholson
• Terri Shenell Nicholson
• Nick H Truong DMD LLC (Cascade of Smiles)
• Nickel N Dime LLC (Precision DME Coding and Billing Experts)
• Elisabeth Marshall Nickels, PH.D.
• Shannon Nickey, LCPC
• Ariel Nickesha Nickie Davies, PSYD
• Amanda Nickles Fader, MD
• Cosette L Nickles, C.R.N.P.

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.