SUSAN NICKLIN


Address: 945 S Riverside Ave, Medford, OR 97501-7841
Phone: 5417895252

SUSAN NICKLIN (NPI# 1790814200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790814200
Entity Type Individual
Full Name SUSAN NICKLIN
Credential PT
Practice Address 945 S Riverside Ave
Medford
OR 97501-7841
Mailing Address 100 E Main St
Suite C
Medford
OR 97501-6041
Practice Telephone 5417895252
Mailing Telephone 5417895526
Mailing Fax Number 5417895203
Enumeration Date 2007-03-02
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2251P0200X Physical Therapist
Specialization: Pediatrics
3217 OR Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 183097 05

Office Location

Street Address 945 S RIVERSIDE AVE
City MEDFORD
State OR
Zip Code 97501-7841

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083827489 Margaret A Boyes-mosley Speech-Language Pathologist 945 S Riverside Ave, Medford, OR 97501-7841 2007-05-08
1104957513 Lynn Halliday-roussell Occupational Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-08
1871622019 Asante Community Services LLC Case Manager/Care Coordinator 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-05
1396874707 Kirsten Ferguson Speech-Language Pathologist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1467581876 Katherine Mcfarland Speech-Language Pathologist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1427187830 Ashley Rejcek Speech-Language Pathologist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1407985815 Barbara H Kozol Occupational Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1306975818 Cynthia Eiynck Occupational Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1932238441 Alice Bowen Physical Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1588793087 Brian Rheault Speech-Language Pathologist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366069494 Brian Snapp Counselor 1191 Hazel St, Medford, OR 97501 2020-07-06
1477174761 Corey Renfree Counselor 1191 Hazel Street, Medford, OR 97501 2020-04-28
1669012928 One of A Kind Therapy LLC Social Worker 916 West 10th St #205, Medford, OR 97501 2020-01-14
1265993620 Star Dialysis LLC Clinic/Center 50 Rossanley Dr, Medford, OR 97501 2019-03-28
1962972463 Karen Elise Roertgen Counselor 328 So. Central Ave., Suite 204, Medford, OR 97501 2018-11-28
1316458813 Rick's Medical Supply, Inc Durable Medical Equipment & Medical Supplies 562 Parsons Drive, Suite 114, Medford, OR 97501 2017-10-24
1750807111 La Clinica Del Valle Family Health Care Center Inc. Clinic/Center 821 N Riverside Ave, Medford, OR 97501 2017-08-17
1992229009 Cassandra Schultz Massage Therapist 824 East Jackson, Suite A, Medford, OR 97501 2017-07-31
1972962355 Robin Clevenger Peer Specialist 301 S Ivy St, Medford, OR 97501 2016-02-15
1154706984 Debbie Diane Orr Behavioral Analyst 1024 West 9th Street, Medford, OR 97501 2015-07-22
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Taxonomy Information

Taxonomy Code 2251P0200X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapist
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134374226 Carlos Villaverde Avilla Physical Therapist 5 Camden Ct, Medford, NY 11763-1583 2008-11-18
1396898441 Johanna Lydia Buck Physical Therapist 400 Crater Lake Ave, Medford, OR 97504-6808 2007-01-20
1932238441 Alice Bowen Physical Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02
1508995010 Bonnie D'mello Physical Therapist 945 S Riverside Ave, Medford, OR 97501-7841 2007-03-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275156101 Pace Pediatric Therapy, Inc. Physical Therapist 3701 Se Milwaukie Ave Ste G, Portland, OR 97202-3835 2020-05-27
1427691740 First Steps Physical Therapy, LLC Physical Therapist 911 Main St Ste 100, Oregon City, OR 97045-1853 2019-10-18
1467804773 Rebecca D. Sander Physical Therapist 17113 Sw Green Heron Dr, Sherwood, OR 97140-8972 2016-07-11
1841426434 Rebecca Additon Veltri Physical Therapist 32513 Joseph Ln, Philomath, OR 97370-9130 2009-06-09
1396943932 Kathleen Marie Hogan Physical Therapist 132 Formac Ave, Eugene, OR 97404-2606 2007-07-05
1306050646 Pediatric Therapyworks Physical Therapist 30714 Se Dodge Park Blvd, Gresham, OR 97080-8961 2007-05-09
1912068941 Sandra Lee Saavedra Physical Therapist 1763 Moss St, Eugene, OR 97403-1946 2006-12-13
1164598462 Joy Danielle Shank Physical Therapist 7203 Se Raymond St, Portland, OR 97206-4323 2006-11-28
1861453979 Therapy Solutions for Kids, LLC Physical Therapist 5200 Sw Macadam Ave, Portland, OR 97239-6103 2006-03-29
1225649205 Jaclyn Silver Physical Therapist 2500 Ne Neff Rd, Bend, OR 97701-6015 2020-08-12
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Competitor

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City MEDFORD
Zip Code 97501

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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