Active NPI
Joe Nickerson
- Registered Nurse
- Gainesville, FL
National Provider Identifier
1265277586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9463797
- Practice address
- 1515 SW Archer Rd
Gainesville, FL 32608-1134 - Phone
- (352) 265-0111
- NPI assigned
- Jun 27, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9463797 | FL | Primary |
Addresses
Primary practice location
1515 SW Archer Rd
Gainesville, FL 32608-1134
Mailing address
3915 NW 7TH PL
Gainesville, FL 32607-4811
Phone (352) 538-5862
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 |
|---|---|---|---|
| RN9463797 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1265277586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 NW 7TH PL",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326074811",
"telephone_number": "352-538-5862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326081134",
"telephone_number": "352-265-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKERSON",
"first_name": "JOE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-27",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9463797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.