Individual provider Active NPI

Nicole Renee Ewry

  • Clinical Social Worker
  • Chillicothe, OH
National Provider Identifier
1235836354
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2507310 Issued in OH
Practice address
17273 State Route 104
Chillicothe, OH 45601-9718
Phone
(740) 773-1141
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2507310 OH Primary

Addresses

Primary practice location

17273 State Route 104
Chillicothe, OH 45601-9718

Mailing address

17273 State Route 104
Chillicothe, OH 45601-9718

Other names 1

  • Nicole Renee Reynolds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I.2507310OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Services for Behavioral Health Clinical PastSince Feb 1, 2023 Accepting new patients
Integrated Services for Behavioral Health PastSince Feb 1, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1235836354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17273 STATE ROUTE 104",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019718",
            "telephone_number": "740-773-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWRY",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2507310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "REYNOLDS",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.