Nichole C Pauley, CST/CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

238.000.120 Issued in IL

Practice address

1604 Visa Dr.
Ste. 1
Normal, IL 61761

Phone

(309) 846-4716

Fax

(309) 454-7348

NPI assigned

Oct 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole C Lappin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1174776843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 VISA DR.",
            "address_2": "STE. 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR.",
            "address_2": "STE. 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "61761",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULEY",
        "first_name": "NICHOLE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CST/CSFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "238.000120",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238.000.120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "LAPPIN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler James Pascavis, MD
• Julia Pascoe, LCSW
• Dhaval Patel, DMD
• Saloniben Girishkumar Patel
• Raju N Paturi, MD
• Jean Pe, MD
• Kennady Pearson
• Meredith Renee Peebles
• Marlon Pemberton
• Pentus Health Wylie Limited

• Surgical Assistant in Normal, IL
• Providers in Normal, IL by specialty
• Surgical Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.