Individual provider Active NPI

Juliane Nicholson

  • Physical Therapy Assistant
  • Toledo, OH
National Provider Identifier
1356766679
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
03640 Issued in OH
Practice address
2831 Gracewood Rd
Toledo, OH 43613-3344
Phone
(419) 410-7002
NPI assigned
Feb 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 03640 OH Primary

Addresses

Primary practice location

2831 Gracewood Rd
Toledo, OH 43613-3344

Mailing address

2831 Gracewood Rd
Toledo, OH 43613-3344
Phone (419) 410-7002

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

State licenses

LicenseStateTypeSpecialty
03640OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1356766679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 GRACEWOOD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436133344",
            "telephone_number": "419-410-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 GRACEWOOD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436133344",
            "telephone_number": "419-410-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JULIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "03640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.