Individual provider Active NPI

Nicole Marie Temple

  • Physical Therapy Assistant
  • Meadville, PA
National Provider Identifier
1821635699
Registry record updated Nov 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE012157 Issued in PA
Practice address
751 Liberty St
Meadville, PA 16335-2591
Phone
(814) 333-5000
NPI assigned
Nov 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A6917 NC
Physical Therapy Assistant 225200000X TE012157 PA Primary

Addresses

Primary practice location

751 Liberty St
Meadville, PA 16335-2591

Mailing address

751 Liberty St
Meadville, PA 16335-2591
Phone (814) 333-5000

Other practice location 1

11277 Vernon Pl
Meadville, PA 16335-3717
Phone (814) 373-3415

Other practice location 2

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5000

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
A6917NCMDPhysical Therapy Assistant
TE012157PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1574985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1821635699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352591",
            "telephone_number": "814-333-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352591",
            "telephone_number": "814-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11277 Vernon Pl",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163353717",
            "country_code": "US",
            "telephone_number": "814-373-3415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1034 Grove St",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352945",
            "country_code": "US",
            "telephone_number": "814-333-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-29",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A6917",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE012157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.