Mary Etta Nichols

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2231 N Taylor Rd
Cleveland Heights, OH 44112-3044

Phone

(216) 441-2496

Fax

(216) 634-9611

NPI assigned

Feb 13, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Jordan Community Residential

  • Mental Health Counselor
  • Willoughby, OH
  • NPI 1467098822
  NPD
• Jordan Community Residential Center

  • Addiction (Substance Use Disorder) Psychologist
  • Willoughby, OH
  • NPI 1164068524
  NPD

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1093348476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 N TAYLOR RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441123044",
            "telephone_number": "216-441-2496",
            "fax_number": "216-634-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 N TAYLOR RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441123044",
            "telephone_number": "216-441-2496",
            "fax_number": "216-634-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARY",
        "middle_name": "ETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsie Neal, APRN, CNM
• Alphonso Neely
• Nephrology and Hypertension Associates Inc.
• Judy Neuman, LISW
• Nicholas M Rudy DDS Inc
• Benisha Nickelberry-Pruitt
• Nicole Denise Nickens, MSN, A-GPNP-BC,
• James Njui, RN
• Kisha Nichelle Noah
• Sara Jane Noble

• Case Manager/Care Coordinator in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.