Organization Active NPI

Harold R Nicolette, DO, PA

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1043478142
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0165 Issued in SC
Legal business name
HAROLD R NICOLETTE, DO, PA
Practice address
6 Carriage LN
Suite B
Charleston, SC 29407-6010
Phone
(843) 766-4100
Fax
(843) 571-4177
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Harold Roy Nicolette, D.O.
Title
President
Phone
(843) 766-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0165 SC Primary

Addresses

Primary practice location

6 Carriage LN
Suite B
Charleston, SC 29407-6010

Mailing address

6 Carriage LN
Suite B
Charleston, SC 29407-6010
Phone (843) 766-4100

Other identifiers 1

IdentifierTypeStateIssuer
001651MedicaidSC

National Provider Directory

National Provider Directory

Locations

6 Carriage Ln
#B
Charleston, SC 29407
Phone (843) 297-8470

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1043478142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CARRIAGE LN",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076010",
            "telephone_number": "843-766-4100",
            "fax_number": "843-571-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CARRIAGE LN",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076010",
            "telephone_number": "843-766-4100",
            "fax_number": "843-571-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD R NICOLETTE, DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "NICOLETTE",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-766-4100",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "0165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001651",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.