Individual provider Active NPI

Nicolle Lang, PT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1720387335
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11270 Issued in NC
Practice address
615 Spring Forest Rd
Raleigh, NC 27609-9150
Phone
(919) 876-8899
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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 11270 NC Primary

Addresses

Primary practice location

615 Spring Forest Rd
Raleigh, NC 27609-9150

Mailing address

733 Champlain CT
Cary, NC 27519-6475
Phone (516) 659-6931

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

LicenseStateTypeSpecialty
11270NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1720387335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 CHAMPLAIN CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196475",
            "telephone_number": "516-659-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276099150",
            "telephone_number": "919-876-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "NICOLLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.