Wendy Lee Nichollls, PTA

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

5502000828 Issued in MI

Practice address

4949 Coolidge Hwy
Royal Oak, MI 48073-1026

Phone

(248) 655-5660

Fax

(248) 655-5662

NPI assigned

Aug 30, 2018

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

Other names 1

• Wendy Lee Nicholls Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1356823058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 BARNESWOOD LN",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483064113",
            "telephone_number": "586-246-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 COOLIDGE HWY",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731026",
            "telephone_number": "248-655-5660",
            "fax_number": "248-655-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLLS",
        "first_name": "WENDY",
        "middle_name": "LEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MI",
            "license": "5502000828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "NICHOLLS",
            "middle_name": "LEE",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Liem T Ngo, MD
• Angel Nguyen, MS, CGC
• Cecilia Thien Thu Si Nguyen, MD
• Dan Nguyen, M.D.
• Summer Niazi, MBBS
• Maureen Nichols, CRNA
• Nola Nichols
• Nick Brooks, PLLC
• Alex Nickel, MD
• Megan Ashley Nicklaus, CRNA

• Pediatric Rehabilitation Medicine Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pediatric Rehabilitation Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.