Sage V Nichelson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT24021 Issued in FL

Practice address

4206 Breslay Dr
Melbourne, FL 32940-8442

Phone

(207) 212-0654

NPI assigned

Jul 10, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Sage Landry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1783641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1114846631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 COASTAL MEADOW TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183546",
            "telephone_number": "207-212-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4206 BRESLAY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408442",
            "telephone_number": "207-212-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHELSON",
        "first_name": "SAGE",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "OT24021",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT24021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAGE",
            "last_name": "LANDRY",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hiep Le Nguyen, M.D.
• Jacqueline Elizabeth Nguyen, PHARMD
• Kieu Nguyen, RPH
• Tuyetduyen Nguyen
• Bo-Shih Ni, L AC
• Chadwick Nichols, PTA
• Imari Nichols
• Jamin A Nichols, AP
• Micheline Nichols, SLP
• Julia Nicholson

• Occupational Therapist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.