Kaitlin Elaine Nicholson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL5015 Issued in FL

Practice address

5598 Sunrise Dr
Fort Myers, FL 33919-1716

Phone

(239) 274-6749

Fax

(239) 274-6787

NPI assigned

Apr 30, 2018

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 1

Other names 1

• Kaitlin Elaine Hughes Former name

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": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1275021768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5598 SUNRISE DR APT 208",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191716",
            "telephone_number": "757-651-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5598 SUNRISE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191716",
            "telephone_number": "239-274-6749",
            "fax_number": "239-274-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KAITLIN",
        "middle_name": "ELAINE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH AT LICENSURE",
            "identifier": "AL5015",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "HUGHES",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Arielle Dominique Nichols, CNM
• John Lee Nichols
• Lydia Patrice Nichols, LPN
• Tyler Jackson Nichols
• Cameron Lee Nicholson, M.D.
• Kimberly A Nicholson, MD
• Antonio Nickel, PA-C
• Ryan Nickens, D.C.
• Diane Nicolette
• Tricia Lynne Nicolette, MS, CCC-SLP

• Athletic Trainer in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.