Active NPI
Nicole L Nolan, DPT
- Physical Therapist
- Penfield, NY
National Provider Identifier
1164701439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 034036-1
- Practice address
- 1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903 - Phone
- (585) 341-9200
- Fax
- (585) 697-0209
- NPI assigned
- Aug 4, 2011
- 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 34036 | NY | |
| Physical Therapist | 225100000X | 034036-1 | NY | Primary |
Addresses
Primary practice location
1835 Fairport Nine Mile Point Rd
Penfield, NY 14526-1903
Mailing address
601 Elmwood Ave Box 665
Rochester, NY 14642-0001
Phone (585) 341-9200
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nnolan51372@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | nnolan51372@direct.urmc.rochester.edu | Direct |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34036 | NY | MD | Child & Adolescent Psychiatry Physician |
| 034036-1 | NY | MD | Physical Therapist |
Interoperability endpoints
- nnolan51372@direct.urmc.rochester.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1164701439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE BOX 665",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-341-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 FAIRPORT NINE MILE POINT RD",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145261903",
"telephone_number": "585-341-9200",
"fax_number": "585-697-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "NICOLE",
"middle_name": "L",
"name_prefix": "Miss",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2023-07-17",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NY",
"license": "34036",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "034036-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nnolan51372@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nnolan51372@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Penfield, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.