Individual provider Active NPI

Freida Nicholson, LPN

  • Licensed Practical Nurse
  • Burlington, NJ
National Provider Identifier
1417100660
Registry record updated Nov 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
26NP05375200 Issued in NJ
Practice address
261 Connecticut Dr
Suite 5
Burlington, NJ 08016-4177
Phone
(800) 950-6066
NPI assigned
Nov 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 26NP05375200 NJ Primary

Addresses

Primary practice location

261 Connecticut Dr
Suite 5
Burlington, NJ 08016-4177

Mailing address

870 E Route 130
Apt B3
Burlington, NJ 08016-2892
Phone (609) 346-6793

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

LicenseStateTypeSpecialty
26NP05375200NJMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1225497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225497600000",
    "number": "1417100660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 E ROUTE 130",
            "address_2": "APT B3",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162892",
            "telephone_number": "609-346-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CONNECTICUT DR",
            "address_2": "SUITE 5",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164177",
            "telephone_number": "800-950-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "FREIDA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-01",
        "last_updated": "2008-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP05375200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2008; 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.