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

Nyckolas Johnson

Individual provider Physical Therapist · NPI 1003767443

Nyckolas Johnson is a Physical Therapist in Private Practice in Greensboro, North Carolina. Qualified in 2025, 1 year ago. Practices with Wake Forest University Health Sciences, a 2,621-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
1
Licensed in
NC
In the registry since
2026
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Practice location Address checks out

708 Pembroke Rd
Greensboro, NC 27408-7610
Phone: (919) 791-6678
Fax: (919) 981-9766
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 861 Old Winston Rd, Kernersville, NC 27284-7140 — (336) 713-3500

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P24695 (NC)

Record details

NPI number1003767443
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 3, 2026
Last updated in NPPESApril 1, 2026
Certification dateApril 1, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Wake Forest University Health Sciences — 2621 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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