Active NPI
Nichol R Denison, PA-C
- Physician Assistant
- Wilkes Barre, PA
National Provider Identifier
1134045107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA068008
- Practice address
- 1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027 - Phone
- (570) 808-7861
- Fax
- (570) 808-1069
- NPI assigned
- Jun 25, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA | ||
| Physician Assistant | 363A00000X | MA068008 | PA | Primary |
Addresses
Primary practice location
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 808-7861
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1134045107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-808-7861",
"fax_number": "570-808-1069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN BLVD",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110027",
"telephone_number": "570-808-7861",
"fax_number": "570-808-1069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENISON",
"first_name": "NICHOL",
"middle_name": "R",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-25",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA068008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.