NICOLE LYNN THAXTON (PT) – Physical Therapist, NPI 1073034252

NICOLE LYNN THAXTON (PT) is a healthcare provider. based in Bolingbrook, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 1290816 (TX). The NPI Number for NICOLE LYNN THAXTON (PT) is 1073034252

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE LYNN THAXTON (PT)
NPI
1073034252
Phone
(630) 296-2222
Address
790 REMINGTON BLVD
Enumeration Date
28 June 2017
Last Update Date
27 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8175767520
Graduation Year
2017 (9 years ago)
PAC ID
1850665084
Group Practice PAC ID
0547583809
Professional Enrollment ID
I20170926003823
Address ID
TX760343986CO4843XBLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

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Provider Addresses for NICOLE LYNN THAXTON (PT)

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone: (630) 296-2222

    Type: Mailing

  • Tuscan Surgery Center at Las Colinas, 701, Tuscan Drive, Las Colinas, Irving, Dallas County, Texas, 75083, United States

    IRVING, TX 750394133

    Phone: (214) 727-8820

    Type: Location

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: 2017-09-26

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
I20170926003823IPhysical Therapist In Private PracticeTXTBD

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
97530Therapy procedure using functional activities83393$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes79295$0
97140Therapy procedure using manual technique, each 15 minutes55478$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes38170$0
97163Evaluation for physical therapy, typically 45 minutes3532$0
View full utilization report →

Insurance plans in this area (ZIP 60440)

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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: 0547583809View full group profile
NameSpecialtyState
-IL
Occupational Therapist In Private PracticeTX
-IL
-TN
-TX
-TX
Occupational Therapist In Private PracticeTX
-TX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeIL

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Frequently asked questions

How do I look up NICOLE LYNN THAXTON (PT) by NPI?
Use NPI 1073034252 when you need to reference NICOLE LYNN THAXTON (PT) in forms, claims, or directories.
Does this profile mean NICOLE LYNN THAXTON (PT) is currently active?
Yes — NICOLE LYNN THAXTON (PT) appears active in the national provider directory.
What does NICOLE LYNN THAXTON (PT) treat or focus on?
Patients typically see NICOLE LYNN THAXTON (PT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place NICOLE LYNN THAXTON (PT)?
The snapshot lists Bolingbrook, Illinois for NICOLE LYNN THAXTON (PT); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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