Isidora Nichols, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 2854 Issued in FL

Practice address

115 Bartram Oaks Walk
Ste. 104
Saint Johns, FL 32259-3243

Phone

(904) 240-0471

Fax

(904) 240-0471

NPI assigned

Feb 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8428/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1194065870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9765 SOUTHBROOK DR",
            "address_2": "APT. 2203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560459",
            "telephone_number": "863-712-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BARTRAM OAKS WALK",
            "address_2": "STE. 104",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322593243",
            "telephone_number": "904-240-0471",
            "fax_number": "904-240-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ISIDORA",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 2854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Jennifer Navas, PA
• Tami Leigh Newbern, ARNP
• Da-Thao Thi Nguyen, DDS
• Abigail Kaplan Niad, MSOT
• Daniel James Nicholls
• Casey Nietz, APRN
• Hebah Zahi Nijem
• North Florida Advanced Hospitalist
• North Florida Anesthesia Consultants Inc
• North Florida Anesthesia Consultants Inc

• Athletic Trainer in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.