Individual provider Active NPI

Brian H Nicholas, L.AC

  • Acupuncturist
  • South Orange, NJ
National Provider Identifier
1174857866
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00066300 Issued in NJ
Practice address
5 Stanley Rd
South Orange, NJ 07079-2700
Phone
(862) 250-5228
NPI assigned
Sep 28, 2009
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00066300 NJ Primary

Addresses

Primary practice location

5 Stanley Rd
South Orange, NJ 07079-2700

Mailing address

125 Elliot PL
East Orange, NJ 07018-1127
Phone (973) 865-0733

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MZ00066300NJMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Akoma Acupuncture and Pranic Healing Acupuncturist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1174857866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ELLIOT PL",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181127",
            "telephone_number": "973-865-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 STANLEY RD",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792700",
            "telephone_number": "862-250-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "BRIAN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-28",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00066300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.