Active NPI
William Nicholson, MD
- Family Medicine Physician
- West Allis, WI
National Provider Identifier
1003830142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37383
- Practice address
- 2514 S 102ND St Ste 160
West Allis, WI 53227-2142 - Phone
- (414) 255-0300
- Fax
- (414) 543-9601
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37383 | WI | Primary |
Addresses
Primary practice location
2514 S 102ND St Ste 160
West Allis, WI 53227-2142
Mailing address
3807 Spring St
Racine, WI 53405-1667
Phone (262) 687-8173
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34383 | WI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1003830142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3807 SPRING ST",
"city": "RACINE",
"state": "WI",
"postal_code": "534051667",
"telephone_number": "262-687-8173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2514 S 102ND ST STE 160",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532272142",
"telephone_number": "414-255-0300",
"fax_number": "414-543-9601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "37383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.