Nicole J Deverteuil-Waggoner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT18177 Issued in FL

Practice address

12341 NW 18TH St
Plantation, FL 33323-2122

Phone

(954) 478-4648

Fax

(954) 530-5694

NPI assigned

Aug 27, 2005

Sex

Female

Sole proprietor

No

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

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.

• Advanced Therapy Concepts of Broward Inc

  • Physical Therapist
  • Plantation, FL
  • NPI 1396778668
  NPD (past)
• Physical Therapy in Your Home Inc

  • Physical Therapy Clinic/Center
  • Boca Raton, FL
  • NPI 1356353437
  NPD (past)
• Trinity 5 Inc

  • Physical Therapist
  • Boca Raton, FL
  • NPI 1326665084
  NPD (past)

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

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992798607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 NW 101ST AVE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211235",
            "telephone_number": "954-258-0415",
            "fax_number": "954-718-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12341 NW 18TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232122",
            "telephone_number": "954-478-4648",
            "fax_number": "954-530-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERTEUIL-WAGGONER",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Sorel Desir, DC
• Daphne Of Desmarattes
• Vavanne Destin, APRN
• Harold Enrique Deulofeut, MD
• Nalini Devabhaktuni, M.D.
• Devine Home and Health,LLC
• Devine Therapeutics, LLC
• Ginger M Devine, OT
• DG Dental Plantation
• Uttma Dham, DMD

• Physical Therapist in Plantation, FL
• Providers in Plantation, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.