MR. BRIAN DAVID NICHOLS (MPT ATC) – Physical Therapist, NPI 1679679088

MR. BRIAN DAVID NICHOLS (MPT ATC) is a healthcare provider. based in Star, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MPT ATC. They hold a License No. 1136 (ID). The NPI Number for MR. BRIAN DAVID NICHOLS (MPT ATC) is 1679679088

Main info

Male
30 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN DAVID NICHOLS (MPT ATC)
NPI
1679679088
Phone
(208) 286-0766
Address
9652 W STATE STREET
Enumeration Date
15 September 2006
Last Update Date
2 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082860766
Graduation Year
1996 (30 years ago)
PAC ID
0143209874
Group Practice PAC ID
0345229068
Professional Enrollment ID
I20040720001598
Address ID
ID836695858ST9652XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:19State licenses:2Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

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Provider Addresses for MR. BRIAN DAVID NICHOLS (MPT ATC)

  • North Star Physical Therapy, 9652, West State Street, Star, Ada County, Idaho, 83669, United States

    STAR, ID 836695858

    Phone: (208) 286-0766

    Fax: (208) 286-0768

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-07-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040720001598IPhysical Therapist In Private PracticeIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes1,23560$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes84261$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care13917$0
97161Evaluation for physical therapy, typically 20 minutes6658$0
View full utilization report →

Insurance plans in this area (ZIP 83669)

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Provider's Procedures

MR. BRIAN DAVID NICHOLS (MPT ATC) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYID97001Physical therapy evaluation5950
PHYSICAL THERAPYID97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes74151

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345229068View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeID
-ID
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeUT

Reviews

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Frequently asked questions

How do I look up MR. BRIAN DAVID NICHOLS (MPT ATC) by NPI?
Use NPI 1679679088 when you need to reference MR. BRIAN DAVID NICHOLS (MPT ATC) in forms, claims, or directories.
Is MR. BRIAN DAVID NICHOLS (MPT ATC)'s NPI currently valid?
The extract we use shows MR. BRIAN DAVID NICHOLS (MPT ATC) as active.
What field does MR. BRIAN DAVID NICHOLS (MPT ATC) work in?
You can think of MR. BRIAN DAVID NICHOLS (MPT ATC) as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is MR. BRIAN DAVID NICHOLS (MPT ATC)'s primary listing?
We display Star, Idaho because that is what the record indicates for MR. BRIAN DAVID NICHOLS (MPT ATC).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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