Kristina Anne Nickerson, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

215045 Issued in TX

Practice address

930 W Centerville Rd Ste C
Garland, TX 75041-5854

Phone

(972) 303-7021

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1275021164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 US HIGHWAY 80 E APT 2067",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491173",
            "telephone_number": "254-205-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W CENTERVILLE RD STE C",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415854",
            "telephone_number": "972-303-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KRISTINA",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "215045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nhan-Ai, LLC
• Habiboola Niamatali, M.D
• Lindsey E Nichols, MSN-FNP
• William Daniel Nicholson III, M.D.
• Daniel Keith Nickell, PHARM.D
• Nicon Healthcare Services,Inc.
• Elisheva Niedelman, D.M.D
• Michael Niedermair
• Natalie A Niemann, LPC
• Olga Patricia Nino Lagos

• Occupational Therapy Assistant in Garland, TX
• Providers in Garland, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.