Active NPI
Ashley Elizabeth Nickell, OD
- Optometrist
- Anaheim, CA
National Provider Identifier
1336679596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 33694
- Practice address
- 5460 E la Palma Ave
Anaheim, CA 92807-2023 - Phone
- (714) 449-7401
- Fax
- (714) 449-7401
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 33694 | CA | Primary |
Addresses
Primary practice location
5460 E la Palma Ave
Anaheim, CA 92807-2023
Mailing address
5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone (714) 449-7401
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33694 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1336679596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5460 E LA PALMA AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928072023",
"telephone_number": "714-449-7401",
"fax_number": "714-992-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5460 E LA PALMA AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928072023",
"telephone_number": "714-449-7401",
"fax_number": "714-449-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKELL",
"first_name": "ASHLEY",
"middle_name": "ELIZABETH",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CA",
"license": "33694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.