Active NPI
Deborah Delee Nicholson, MS
- Audiologist
- Port Arthur, TX
National Provider Identifier
1396910113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 50489
- Practice address
- 2935 Park Plaza LN
Port Arthur, TX 77642-5516 - Phone
- (409) 985-2529
- Fax
- (409) 985-3565
- NPI assigned
- Apr 23, 2008
- Last updated
- Jan 31, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 50489 | TX | Primary |
Addresses
Primary practice location
2935 Park Plaza LN
Port Arthur, TX 77642-5516
Mailing address
2935 Park Plaza LN
Port Arthur, TX 77642-5516
Phone (409) 985-2529
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112785401 | Medicaid | TX |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1396910113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2935 PARK PLAZA LN",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776425516",
"telephone_number": "409-985-2529",
"fax_number": "409-985-3565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2935 PARK PLAZA LN",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776425516",
"telephone_number": "409-985-2529",
"fax_number": "409-985-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "DEBORAH",
"middle_name": "DELEE",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "50489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112785401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Arthur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.