Active NPI
Eric B Nicholson, MD, PHD
- Psychiatry Physician
- Norwalk, CT
National Provider Identifier
1356779748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 037825
- Practice address
- 16 River Street
Norwalk, CT 06850 - Phone
- (203) 838-8168
- NPI assigned
- Oct 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 037825 | CT | Primary |
| Addiction Psychiatry Physician | 2084P0802X | 037825 | CT |
Addresses
Primary practice location
16 River Street
Norwalk, CT 06850
Mailing address
16 River Street
Norwalk, CT 06850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 5, 2015 through Nov 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037825 | CT | MD | Addiction Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1356779748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 RIVER STREET",
"city": "NORWALK",
"state": "CT",
"postal_code": "06850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 RIVER STREET",
"city": "NORWALK",
"state": "CT",
"postal_code": "06850",
"telephone_number": "203-838-8168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "ERIC",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-22",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "037825",
"primary": true
},
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "CT",
"license": "037825",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.