Active NPI
Nicole E Auld, PA-C
- Physician Assistant
- Winter Park, FL
National Provider Identifier
1174133391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9113220
- Practice address
- 2825 Mulford Ave
Winter Park, FL 32789-6624 - Phone
- (407) 754-6136
- NPI assigned
- Aug 3, 2020
- Last updated
- Jan 3, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9113220 | FL | Primary |
Addresses
Primary practice location
2825 Mulford Ave
Winter Park, FL 32789-6624
Mailing address
2825 Mulford Ave
Winter Park, FL 32789-6624
Phone (407) 754-6136
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9113220 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1174133391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 MULFORD AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327896624",
"telephone_number": "407-754-6136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 MULFORD AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327896624",
"telephone_number": "407-754-6136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AULD",
"first_name": "NICOLE",
"middle_name": "E",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-03",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9113220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.