Michael Nichols, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

31808 Issued in FL

Practice address

107 Cleveland Ave # 2
Cocoa Beach, FL 32931-4009

Phone

(321) 794-2926

NPI assigned

Aug 25, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• In Balance Rehab LLC

  • Physical Therapist
  • Cocoa Beach, FL
  • NPI 1225362312
  Medicare reassignment NPD

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1972116317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 BLAKEY BLVD",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329312804",
            "telephone_number": "321-794-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CLEVELAND AVE # 2",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329314009",
            "telephone_number": "321-794-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Charles Nawrocki, D.M.D F.A.G.D
• Autumn Brooke Neilson, L.M.T
• Jill Ann Neilson, L.M.T.
• Nextgen Pathology
• Megan Nichols
• Caitlin Elizabeth Noah, IDMT
• David L Nutter, MA/MFT
• Shannon O'Bryan, PA
• Karen Ohern, ARNP
• Richard Ohern, M.D., PH.D.

• Physical Therapist in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.