Organization Active NPI

Nicholson Medical Associates,P.C.

  • Family Medicine Physician
  • Conshohocken, PA
National Provider Identifier
1215974589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NICHOLSON MEDICAL ASSOCIATES,P.C.
Practice address
103 E 5TH Ave
Conshohocken, PA 19428-1712
Phone
(610) 828-6990
Fax
(610) 828-7364
NPI assigned
Jun 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Joseph Nicholson, D.O.NPI 1952342420
Title
Medical Director
Phone
(610) 828-6990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

103 E 5TH Ave
Conshohocken, PA 19428-1712

Mailing address

103 E 5TH Ave
Conshohocken, PA 19428-1712
Phone (610) 828-6990

Other names 1

  • Nicholson Medical Associates,P.c. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000637 PA Part B Supplier - Clinic/Group Practice 8426037581 Receives reassigned benefits from 3 practitioners
Practice locations: Conshohocken, PA; Norristown, PA

National Provider Directory

National Provider Directory

Locations

103 E 5th Ave
Conshohocken, PA 19428
Phone (215) 828-5990

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215974589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E 5TH AVE",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281712",
            "telephone_number": "610-828-6990",
            "fax_number": "610-828-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 5TH AVE",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281712",
            "telephone_number": "610-828-6990",
            "fax_number": "610-828-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLSON MEDICAL ASSOCIATES,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "610-828-6990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicholson Medical Associates,P.c.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Conshohocken, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.