Nicole A Stines, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

005228 Issued in IA

Practice address

300 N 4TH Ave E
Suite G
Newton, IA 50208-3155

Phone

(641) 792-1273

Fax

(641) 791-4852

NPI assigned

Nov 15, 2013

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

Other identifiers 2

Other names 1

• Nicole A Moklestad Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Integrated Physical Therapy and Sports Medicine PLLC

  • Physical Therapist
  • Des Moines, IA
  • NPI 1083963037
  NPD (past)
• Mercy Medical Center - Newton

  • Nurse Practitioner
  • Newton, IA
  • NPI 1518687532
  NPD (past)

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1871923649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N 4TH AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083135",
            "telephone_number": "641-792-1273",
            "fax_number": "641-791-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 4TH AVE E",
            "address_2": "SUITE G",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083155",
            "telephone_number": "641-792-1273",
            "fax_number": "641-791-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINES",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "005228",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "14798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF PHYSICAL THERAPY",
            "identifier": "14798",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "005228",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MOKLESTAD",
            "middle_name": "A",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Newton, IA
• Providers in Newton, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.