Individual provider Active NPI

Stephanie Nicholson

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1003390832
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.169214.MEDS-IV Issued in OH
Practice address
765 Pierce Dr
Columbus, OH 43223-2425
Phone
(614) 223-1650
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.169214.MEDS-IV OH Primary

Addresses

Primary practice location

765 Pierce Dr
Columbus, OH 43223-2425

Mailing address

1022 Quarry Park Dr
Reynoldsburg, OH 43068-9790
Phone (614) 288-0819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN.169214.MEDS-IVOHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1003390832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 QUARRY PARK DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430689790",
            "telephone_number": "614-288-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 PIERCE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232425",
            "telephone_number": "614-223-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.169214.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.