Donna Shemanne Nickerson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

36829 Issued in TX

Practice address

621 SW Johnson Ave
Burleson, TX 76028-5833

Phone

(817) 374-0155

NPI assigned

May 22, 2014

Last updated

May 22, 2014By the provider in NPPES

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• 3 Dimension Inc

  • Clinical Social Worker
  • Grand Prairie, TX
  • NPI 1942608658
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1215349311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24223",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761241223",
            "telephone_number": "817-374-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SW JOHNSON AVE",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285833",
            "telephone_number": "817-374-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "DONNA",
        "middle_name": "SHEMANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "36829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinn Nguyen, PHARMD
• Stephanie Chan Nguyen
• Tammy Nguyen, LCSW
• Bethany Nichols, PTA
• Matthew Nickell, MD
• Olga Nikitina, LPC
• Barbra Nix
• No Limits Staffing Services
• Fahad Noman, DO
• Matthew Norby, LMSW

• Clinical Social Worker in Burleson, TX
• Providers in Burleson, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.