Nichelle E. Wiggins, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31156 Issued in TX

Practice address

3804 E Lancaster Ave
Fort Worth, TX 76103-3523

Phone

(817) 744-8355

Fax

(817) 744-8356

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Choice Medical Institute

  • Local Education Agency (LEA)
  • Indianapolis, IN
  • NPI 1477138709
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1043429426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200156",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760060156",
            "telephone_number": "817-744-8355",
            "fax_number": "817-744-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033523",
            "telephone_number": "817-744-8355",
            "fax_number": "817-744-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "NICHELLE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096940401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Rose Wiechmann, PHD
• Kasi Elaine Wielenga
• Jennifer Marie Wiernas, OD
• Carol Michelle Wiesner, NP
• Erin Nichelle Wiggins, M.A., LPC
• Ryley Faye Wiggins
• Kate Michael Wigginton, MD
• Anne M Wiggs, LPC
• Zachary Wight, DPT
• Ryan Wigley, DPT

• Clinical Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.