Active NPI
Ted Wayne Nichols
- Marriage & Family Therapist
- Mebane, NC
National Provider Identifier
1417237462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0717000648
- Practice address
- 7823 Dairy Ridge Rd
Mebane, NC 27302-9281 - Phone
- (919) 563-1927
- NPI assigned
- Aug 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0717000648 | VA | Primary |
Addresses
Primary practice location
7823 Dairy Ridge Rd
Mebane, NC 27302-9281
Mailing address
7823 Dairy Ridge Rd
Mebane, NC 27302-9281
Phone (919) 563-1927
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 |
|---|---|---|---|
| 0717000648 | VA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1417237462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7823 DAIRY RIDGE RD",
"city": "MEBANE",
"state": "NC",
"postal_code": "273029281",
"telephone_number": "919-563-1927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7823 DAIRY RIDGE RD",
"city": "MEBANE",
"state": "NC",
"postal_code": "273029281",
"telephone_number": "919-563-1927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "TED",
"middle_name": "WAYNE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-23",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0717000648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mebane, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.