Active NPI
Danielle Nicholson, D.O.
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1043573363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OT014595
- Practice address
- 3550 Market St FL 4
Chca Chop Campus
Philadelphia, PA 19104-3368 - Phone
- (215) 590-2178
- Fax
- (215) 590-4619
- NPI assigned
- Jun 21, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OT014595 | PA | Primary |
Addresses
Primary practice location
3550 Market St FL 4
Chca Chop Campus
Philadelphia, PA 19104-3368
Mailing address
100 E Penn SQ FL 9
Chca Chop Campus
Philadelphia, PA 19107-3377
Phone (267) 425-9232
Other names 1
- Danielle Walters
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT014595 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital of Philadelphia | Pediatrics | Past | Accepting new patients |
| Windber Hospital, Inc. | Past | Accepting new patients | |
| Riddle Memorial Hospital | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Erdenheim, PA
- NPI 1831262732
-
- General Acute Care Hospital
- Media, PA
- NPI 1407856099
-
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459123200000",
"number": "1043573363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ FL 9",
"address_2": "CHCA CHOP CAMPUS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073377",
"telephone_number": "267-425-9232",
"fax_number": "267-425-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 MARKET ST FL 4",
"address_2": "CHCA CHOP CAMPUS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043368",
"telephone_number": "215-590-2178",
"fax_number": "215-590-4619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "DANIELLE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-21",
"last_updated": "2016-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "OT014595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANIELLE",
"last_name": "WALTERS",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.