Active NPI
Jessica Nicholson
- Speech-Language Pathologist
- Inman, SC
National Provider Identifier
1407190739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9160
- Practice address
- 2017 Brother Arthur TRL
Inman, SC 29349-4000 - Phone
- (954) 736-0278
- NPI assigned
- Nov 27, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9160 | SC | Primary |
| Speech-Language Pathologist | 235Z00000X | SA18011 | FL |
Addresses
Primary practice location
2017 Brother Arthur TRL
Inman, SC 29349-4000
Mailing address
2017 Brother Arthur TRL
Inman, SC 29349-4000
Phone (954) 736-0278
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9160 | SC | MD | Psychiatry Physician |
| SA18011 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756857600000",
"number": "1407190739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2017 BROTHER ARTHUR TRL",
"city": "INMAN",
"state": "SC",
"postal_code": "293494000",
"telephone_number": "954-736-0278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2017 BROTHER ARTHUR TRL",
"city": "INMAN",
"state": "SC",
"postal_code": "293494000",
"telephone_number": "954-736-0278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-27",
"last_updated": "2025-09-03",
"certification_date": "2025-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "9160",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA18011",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inman, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.