Andrew M Nicholson, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

OH 116 Issued in OH

Practice address

300 S Smyser Rd
Wooster, OH 44691-9394

Phone

(330) 465-7048

Fax

(330) 345-3800

NPI assigned

Jul 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053331033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S SMYSER RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919394",
            "telephone_number": "330-465-7048",
            "fax_number": "330-345-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S SMYSER RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919394",
            "telephone_number": "330-465-7048",
            "fax_number": "330-345-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "OH 116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALIST/TECHNOLOGIST-",
            "identifier": "2255A2300X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Thomas Newsom, LSW
• Deidre Neyhart-McIntosh, M.D.
• Alan Nicholas, LSW
• Cassandra Nicholas, M. ED., ED. S., NCSP
• Melissa S Nichols, QMHS
• Nick Amster, Inc.
• Amanda Alysse Nickles, QMHS
• Paul Robert Nielsen, MD, MS
• Courtney Nieschwitz, PT
• Bristen Nign, COTA

• Athletic Trainer in Wooster, OH
• Providers in Wooster, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.