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

Niccole J Mack, DPT

Individual provider Physical Therapist · NPI 1063401503

Niccole J Mack, DPT is a Physical Therapist in Private Practice in Watertown, South Dakota. Qualified in 2003, 23 years ago. Practices with Sanford Medical Center, a 842-clinician group and accepts Medicare assignment. Licensed in South Dakota.

Years since qualifying
23
Licensed in
SD
In the registry since
2005
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

901 4th St NW
Watertown, SD 57201-1558
Phone: (605) 886-8471
Fax: (605) 886-9317
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1225 (SD)

Record details

NPI number1063401503
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 18, 2005
Last updated in NPPESNovember 5, 2013

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Sanford Medical Center — 842 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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