Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Nicholson, PT, DPT

Individual provider Physical Therapist · NPI 1114430725

Jacqueline Nicholson, PT, DPT is a Physical Therapist in Private Practice in Jefferson, Wisconsin. Qualified in 2016, 10 years ago. Practices with Aegis Group Practice LLC, a 406-clinician group and accepts Medicare assignment.

Years since qualifying
10
In the registry since
2017
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1130 Collins Rd
Jefferson, WI 53549-2939
Phone: (262) 470-6950
Fax: (262) 470-6950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1114430725
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedNovember 6, 2017
Last updated in NPPESNovember 6, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Aegis Group Practice Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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