Active NPI
Carlene Nichols
- Occupational Therapist
- Bellingham, WA
National Provider Identifier
1245662501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00003495
- Practice address
- 335 W King Tut Rd
Bellingham, WA 98226-9652 - Phone
- (206) 819-3905
- NPI assigned
- Aug 8, 2013
- Last updated
- Aug 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT00003495 | WA | Primary |
Addresses
Primary practice location
335 W King Tut Rd
Bellingham, WA 98226-9652
Mailing address
3911 Dogwood PL
Mount Vernon, WA 98274-8750
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT00003495 | WA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fidalgo Island Pediatric Occupational Therapy Services PLLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Anacortes, WA
- NPI 1003576257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375920000000",
"number": "1245662501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3911 DOGWOOD PL",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982748750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 W KING TUT RD",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982269652",
"telephone_number": "206-819-3905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "CARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-08",
"last_updated": "2013-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT00003495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.