Lisa Nichols, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

26214261 Issued in GA

Practice address

1220 W Wheeler Pkwy
Augusta, GA 30909-6625

Phone

(404) 422-6747

NPI assigned

Jun 11, 2015

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

State licenses

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1376924746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 HENRY ST",
            "address_2": "#27",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093877",
            "telephone_number": "404-422-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W WHEELER PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096625",
            "telephone_number": "404-422-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "LISA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "26214261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vy Nguyen
• William Philip Duc Nguyen, DO
• Billy Michael Nichols, MD
• Charles William Nichols Jr., PH.D.
• Fenwick T. Nichols, MD
• Martha Easler Nichols, MD
• Stephanie Blackett Nichols, LCSW
• Brianna Taylor Nicholson
• Lee Anna Melissa Nicholson
• Matthew Steven Nicholson, M.D.

• Athletic Trainer in Augusta, GA
• Providers in Augusta, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.