Healthcare Provider Details

I. General information

NPI: 1023290079
Provider Name (Legal Business Name): SEAN THOMAS NIXON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2007
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CORNING RD
CARY NC
27518-9229
US

IV. Provider business mailing address

241 CONGAREE DR
HOLLY SPRINGS NC
27540-6007
US

V. Phone/Fax

Practice location:
  • Phone: 919-431-7400
  • Fax:
Mailing address:
  • Phone: 919-389-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP11339
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: