Individual provider Active NPI

Nicole Pierre-Louis, PTA

  • Physical Therapy Assistant
  • Bay Shore, NY
National Provider Identifier
1932459252
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306603402 Issued in VA
Practice address
245 Locust Dr.
Bay Shore, NY 11706
Phone
(631) 560-4178
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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 2306603402 VA Primary
Physical Therapy Assistant 225200000X 008428 NY

Addresses

Primary practice location

245 Locust Dr.
Bay Shore, NY 11706

Mailing address

245 Locust Dr
Bay Shore, NY 11706-2130
Phone (631) 560-4178

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
008428NYMDPhysical Therapy Assistant
2306603402VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1932459252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 LOCUST DR",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062130",
            "telephone_number": "631-560-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 LOCUST DR.",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-560-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE-LOUIS",
        "first_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603402",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.