NICHOLE JEAN BURGESS (NPI# 1447880778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447880778 |
| Entity Type | Individual |
| Full Name | NICHOLE JEAN BURGESS |
| Credential | LMT |
| Practice Address |
1230 Ruston Pass Ste B Fort Wayne IN 46825-1572 |
| Practice Telephone | 2607976100 |
| Mailing Telephone | 2607976100 |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT22007086 | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102598 | Nichole Therese Burgess | Behavior Technician | 51145 Nicolette Dr, Chesterfield, MI 48047-4585 | 2020-10-23 |
| 1265838866 | Nichole Burgess | Counselor | 1895 Brightseat Rd, Landover, MD 20785-4250 | 2014-11-08 |
| 1588939268 | Nichole Burgess | Counselor | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2012-03-14 |
| Street Address |
1230 RUSTON PASS STE B |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284487 | Jessica Wright | Massage Therapist | 1230 Ruston Pass Ste B, Fort Wayne, IN 46825-1572 | 2020-01-07 |
| 1437799293 | Lora Strong | Massage Therapist | 1230 Ruston Pass Ste B, Fort Wayne, IN 46825-1572 | 2020-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677604 | Dameta Diane Williams | Massage Therapist | 3525 Lake Ave, Fort Wayne, IN 46805-5599 | 2020-10-21 |
| 1386284487 | Jessica Wright | Massage Therapist | 1230 Ruston Pass Ste B, Fort Wayne, IN 46825-1572 | 2020-01-07 |
| 1861031510 | Bristol Auburn Witte | Massage Therapist | 3215 N Anthony Blvd Ste D, Fort Wayne, IN 46805-2259 | 2019-12-29 |
| 1942862024 | Nikya Lowry | Massage Therapist | 6014 Brandy Chase Cv, Fort Wayne, IN 46815-7601 | 2019-06-28 |
| 1154985224 | Shelley Ann Vogelgesang | Massage Therapist | 347 Airport North Office Park, Fort Wayne, IN 46825-6703 | 2019-04-24 |
| 1245796093 | Jonquil Jones | Massage Therapist | 2430 Lake Ave, Fort Wayne, IN 46805-5406 | 2019-02-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1982063582 | Bonnie May Barlow | Massage Therapist | 3634 New Vision Dr, Fort Wayne, IN 46845-1706 | 2016-02-11 |
| 1851775209 | Stephanie Florin | Massage Therapist | 5111 N Bend Dr, Fort Wayne, IN 46804-1753 | 2015-07-15 |
| 1588066914 | Sara Matteucci | Massage Therapist | 3102 Mallard Cove Ln, Fort Wayne, IN 46804-2882 | 2014-09-17 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on NICHOLE JEAN BURGESS.
| 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.