Carol Jean Nicholson, OTRL, CHT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT00000928 Issued in WA

Practice address

9650 15TH Ave SW
Seattle, WA 98106-2576

Phone

(206) 965-1000

Fax

(206) 965-1031

NPI assigned

Apr 4, 2007

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

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.

• Sea Mar Community Health Centers

  dba Sea Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  dba Proliance Surgeons Orthopedic Specialists of Seattle

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment NPD
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment NPD
• Proliance Surgeons, Inc., P.S.

  dba Proliance Sports Therapy and Rehabilitation of Bellevue

  • Physical Therapist
  • Bellevue, WA
  • NPI 1831138783

  Occupational Therapist

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Burien, WA
  • NPI 1245387679
  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642

  Occupational Therapist

  NPD
• The Polyclinic PLLC

  dba Optum Tacoma

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD
• Sea-Mar Community Health Center

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1942358817
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1235251745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 15TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981062576",
            "telephone_number": "206-965-1000",
            "fax_number": "206-965-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "credential": "OTRL, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00000928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103126",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROVIDER NUMBER",
            "identifier": "137579",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Onica Nichols, LSWAIC
• Sara Ashley Nichols, DPT
• William W. Nichols, MD
• Shierry Weber Nicholsen, L.M.H.C.
• Bradley L. Nicholson, MD
• Carrie Erica Nicholson
• Cornelius Adolphus Nicholson, DDS
• Katlin Michele Nicholson
• Martha Nicholson, LMT
• Micah Aaron Nicholson, DDS

• Occupational Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.