Active NPI
Kylie Nicholson
- Occupational Therapist
- Salisbury, MD
National Provider Identifier
1164019279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 09172
- Practice address
- 1336 Belmont Ave Ste 502
Salisbury, MD 21804-4500 - Phone
- (410) 546-2894
- NPI assigned
- Dec 22, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 09172 | MD | Primary |
Addresses
Primary practice location
1336 Belmont Ave Ste 502
Salisbury, MD 21804-4500
Mailing address
326 Androssan PL
Townsend, DE 19734-2861
Phone (302) 373-4670
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09172 | MD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Delaware & Maryland's Eastern Shore | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rehabilitation Clinic/Center
- Salisbury, MD
- NPI 1013392968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1164019279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 ANDROSSAN PL",
"city": "TOWNSEND",
"state": "DE",
"postal_code": "197342861",
"telephone_number": "302-373-4670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1336 BELMONT AVE STE 502",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218044500",
"telephone_number": "410-546-2894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "KYLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-22",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "09172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.