Timothy James Nichols, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6301 Issued in TN

Practice address

851 Professional Park Dr
Clarksville, TN 37040-5257

Phone

(901) 517-5858

NPI assigned

Jun 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1205496437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 EDINBURGH WAY",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433853",
            "telephone_number": "901-517-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405257",
            "telephone_number": "901-517-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "6301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "advancedtherapy@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "Site email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "851 Professional Park Dr",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Van Nguyen, PT, DPT
• Babacar Niang, MD
• Carol A. Nichols, M.ED., L.M.F.T.
• Depaul Nichols
• Richard Cory Nichols, RBT
• Lauren Nicholson
• Dawn Marie Nichter
• Stephanie Renee Nickell
• Matthew Alan Nicolai
• Darin A Nielsen, MDIV, LMFT-TN

• Pediatric Occupational Therapist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Pediatric Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.