Active NPI
Leanne Marie Nichols, MA, AT, ATC, PES
- Athletic Trainer
- Howell, MI
National Provider Identifier
1104313709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601000838
- Practice address
- 4128 E Grand River Ave
Howell, MI 48843-6538 - Phone
- (517) 540-1060
- Fax
- (517) 540-1063
- NPI assigned
- Apr 18, 2018
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601000838 | MI | Primary |
Addresses
Primary practice location
4128 E Grand River Ave
Howell, MI 48843-6538
Mailing address
144 Manchester LN Apt 3211
Waterford, MI 48327-2357
Phone (810) 874-9122
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601000838 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524009600000",
"number": "1104313709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 MANCHESTER LN APT 3211",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483272357",
"telephone_number": "810-874-9122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4128 E GRAND RIVER AVE",
"city": "HOWELL",
"state": "MI",
"postal_code": "488436538",
"telephone_number": "517-540-1060",
"fax_number": "517-540-1063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "LEANNE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MA, AT, ATC, PES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-18",
"last_updated": "2018-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601000838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Howell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.