Nicholas Massie
Individual provider Active NPI Sports Medicine (Emergency Medicine) Physician · Gambier, OH
NPI 1174140404 · NPPES record last updated Jul 2, 2020
Key facts
- NPI
- 1174140404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Emergency Medicine) Physician 207PS0010X
- License
- RT006173 (PA)
- Practice address
- 221 Duff St
Gambier, OH 43022-5013 - Phone
- (937) 926-1208
- NPI assigned
- Jul 2, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT006173 | PA | MD | Sports Medicine (Emergency Medicine) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | RT006173 | PA | Yes |
Addresses
Primary practice location
221 Duff St
Gambier, OH 43022-5013
Mailing address
222 Crabapple Dr
Howard, OH 43028-8038
Phone (937) 926-1208
Other providers in Gambier, OH
- Gina Ann Grosscup
- Landra Houston
- Kathryn Makay Johnson
- Kristi Kirk
- Margaret Lynn Lewis
- Wendy Colleen McCullough
- Scott James Peppel
- Florence Schermer
- Bryant Staats
- John T Vanwey
All providers in Gambier, OH · Sports Medicine (Emergency Medicine) Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.