Edward C Nickerson, RPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT12609 Issued in CA

Practice address

2801 K St
Ste 310
Sacramento, CA 95816-5120

Phone

(916) 353-2270

Fax

(916) 353-2279

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fitzpatrick Physical Therapy IncGroup PAC ID 4183674724, 9 clinicians

Practice addresses (Care Compare)

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.

• Fitzpatrick Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Placerville, CA
  • NPI 1295783900
  Medicare reassignment Care Compare group NPD
• Sacramento Knee & Sports Medicine

  • Orthopaedic Surgery Physician
  • Sacramento, CA
  • NPI 1922115575
  Medicare reassignment
• Schaack Physical Therapy PC

  • Physical Therapist
  • Lincoln, CA
  • NPI 1477987261
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992820518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11251 COLOMA RD",
            "address_2": "STE J",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704431",
            "telephone_number": "916-353-2270",
            "fax_number": "916-353-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 K ST",
            "address_2": "STE 310",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165120",
            "telephone_number": "916-353-2270",
            "fax_number": "916-353-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "EDWARD",
        "middle_name": "C",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT12609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PT90581",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDL",
            "identifier": "12300100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PT12609",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tosha Nichols, RN
• Travis George Nichols
• William Gary Nichols, LCSW
• Chase Samuel Nicholson, DO
• Katherine Elizabeth Nicholson
• Gasong Yun Nickerson
• William A. Nickerson, MD
• Sydney Dawn Nickolas
• Nicobre Health Services
• Alexis C Nicodemus

• Specialist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.