Individual provider Active NPI

Nicole L Nolan, DPT

  • Physical Therapist
  • Penfield, NY
National Provider Identifier
1164701439
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034036-1 Issued in NY
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

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
34036NYMDChild & Adolescent Psychiatry Physician
034036-1NYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.