Patricia R Nichols, RPT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012279 Issued in GA

Practice address

2455 Oak Grove Church Rd
Carrollton, GA 30117-9513

Phone

(770) 834-1737

NPI assigned

Jul 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1770712853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 OAK GROVE CHURCH RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301179513",
            "telephone_number": "334-669-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 OAK GROVE CHURCH RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301179513",
            "telephone_number": "770-834-1737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Cahaba Valley Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351242217",
            "country_code": "US",
            "telephone_number": "205-942-6820",
            "fax_number": "205-942-6292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RPT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "1595",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.