Nicole Rae Balsom

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

150 Holly LN
Chagrin Falls, OH 44022-4198

Phone

(609) 558-4007

NPI assigned

Aug 10, 2023

Last updated

Aug 10, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pieces Early Learning, LLC

  • Community/Behavioral Health Agency
  • Chagrin Falls, OH
  • NPI 1245848498
  NPD (past)

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1295418713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37406 PARK AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440946051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HOLLY LN",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224198",
            "telephone_number": "609-558-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSOM",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aziza Wahby DO
• Bainbride Dental Associates
• Bainbridge Dental Associates, Inc
• Bainbridge Township
• Melissa Anne Baker, MS CCC-SLP
• Amy Baraona, PT
• Carla Basconi, DPT
• Allyson Bates
• Annabella Batiz-McCandlish, BSW, MSW
• Beacon Orthopaedics & Sports Medicine, LTD (Precision Orthopaedic Specialties, Inc. DBA OrthoAlliance of Ohio)

• Behavior Analyst in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.