Individual provider Active NPI

Nikodemas Simonas McNulty, N.D.

  • Naturopath
  • Encinitas, CA
National Provider Identifier
1124425434
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
698 Issued in CA
Practice address
531 Encinitas Blvd Ste 121
Encinitas, CA 92024-3773
Phone
(858) 800-2555
Fax
(858) 800-2555
NPI assigned
Dec 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NATU.NT.60505930 WA
Massage Therapist 225700000X MA 60297086 WA
Naturopath 175F00000X 698 CA Primary

Addresses

Primary practice location

531 Encinitas Blvd Ste 121
Encinitas, CA 92024-3773

Mailing address

531 Encinitas Blvd Ste 121
Encinitas, CA 92024-3773
Phone (858) 800-2555

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

State licenses

LicenseStateTypeSpecialty
698CAMDDental Hygienist
NATU.NT.60505930WAMDNaturopath
MA 60297086WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nature & Science Medicine Naturopathic Clinic, Apc CurrentSince Oct 8, 2023 Accepting new patients

Locations

531 Encinitas Blvd
Ste 121
Encinitas, CA 92024
Phone (858) 800-2555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1124425434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ENCINITAS BLVD STE 121",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243773",
            "telephone_number": "858-800-2555",
            "fax_number": "858-800-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 ENCINITAS BLVD STE 121",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243773",
            "telephone_number": "858-800-2555",
            "fax_number": "858-800-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "NIKODEMAS",
        "middle_name": "SIMONAS",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NATU.NT.60505930",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60297086",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.