Nikole Decker Squires, LAT, ATC, CPT is a
Specialist/technologist - Athletic Trainer physician based in Highland, Utah. Nikole Decker Squires is licensed to practice in Utah (license number 10877423-4810) and her current practice location is 6748 W 9500 N, Highland, Utah. She can be reached at her office (for appointments etc.) via phone at
(480) 318-3949.
NPI number for Nikole Decker Squires is 1215493838 and her current mailing address is 290 N 1260 W, Provo, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215493838.
Physician's Profile
| Full Name | Nikole Decker Squires |
|---|
| Gender | Female |
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| Speciality | Specialist/technologist - Athletic Trainer |
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| Location | 6748 W 9500 N, Highland, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1215493838
- Provider Enumeration Date: 02/19/2019
- Last Update Date: 02/19/2019
Medical Identifiers
Medical identifiers for Nikole Decker Squires such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215493838 | NPI | - | NPPES |
| 10877423-4810 | Other | UT | UT DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING |
| 2000031617 | Other | | NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION, INC. |
| TBA | Other | | NATIONAL ACADEMY OF SPORTS MEDICINE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 10877423-4810 (Utah) | Secondary |
| 2083S0010X | Preventive Medicine - Sports Medicine | 10877423-4810 (Utah) | Secondary |
| 405300000X | Prevention Professional | TBA (Utah) | Secondary |
| 2255A2300X | Specialist/technologist - Athletic Trainer | 10877423-4810 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nikole Decker Squires is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nikole Decker Squires, LAT, ATC, CPT
290 N 1260 W,
Provo, UT 84601-2436
Ph: (480) 318-3949 | Nikole Decker Squires, LAT, ATC, CPT
6748 W 9500 N,
Highland, UT 84003-3455
Ph: (480) 318-3949 |
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