Active NPI
Kim Nichols
- Health Educator
- Indianapolis, IN
National Provider Identifier
1275356511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 5315 Lafayette Rd
Indianapolis, IN 46254-1618 - Phone
- (317) 297-9622
- NPI assigned
- Nov 5, 2024
- 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 |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
5315 Lafayette Rd
Indianapolis, IN 46254-1618
Mailing address
6610 N Shadeland Ave
Indianapolis, IN 46220-4392
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uho - YMCA of Metropolitan Milwaukee | Health Educator | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1275356511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6610 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462204392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5315 LAFAYETTE RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462541618",
"telephone_number": "317-297-9622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-05",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.