Individual provider Active NPI

Emily Elizabeth Nichols, COTA

  • Occupational Therapy Assistant
  • Brockton, MA
National Provider Identifier
1043715063
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
801 Pleasant St
Brockton, MA 02301-3052
Phone
(508) 586-5977
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X Primary

Addresses

Primary practice location

801 Pleasant St
Brockton, MA 02301-3052

Mailing address

12 Harnden Rd
Foxborough, MA 02035-1250
Phone (508) 785-5015

Other practice location 1

120 Murray St
Medford, MA 02155-1300
Phone (781) 391-0800

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

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1043715063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HARNDEN RD",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020351250",
            "telephone_number": "508-785-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013052",
            "telephone_number": "508-586-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Murray St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021551300",
            "country_code": "US",
            "telephone_number": "781-391-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.