Sandra L Nicholson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA002412 Issued in PA

Practice address

367 Route 28
Brookville, PA 15825-7161

Phone

(814) 849-0833

Fax

(814) 849-1288

NPI assigned

Feb 18, 2008

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

Other identifiers 1

Other names 1

• Sandra L Klingensmith Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sandra.nicholson@direct-address.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Butler Medical Providers

  • Gastroenterology Physician
  • Butler, PA
  • NPI 1619493046
  Medicare reassignment
• Butler Medical Providers

  • Rural Health Clinic/Center
  • Fairmount City, PA
  • NPI 1386253854
  NPD
• Butler Medical Providers

  dba Butler Pathology Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Butler, PA
  • NPI 1447283031
  NPD (past)

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1437327079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DOCTORS LN",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148515",
            "telephone_number": "814-226-3470",
            "fax_number": "814-226-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ROUTE 28",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158257161",
            "telephone_number": "814-849-0833",
            "fax_number": "814-849-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103275090 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "KLINGENSMITH",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sue Stayer Moran, P.T.
• Elizabeth Neeman, LSW
• James Newsome, MA
• Louis D Nichamin, M.D.
• Erika Nicholson
• Terrence M Nicholson, PHARMD
• Mollie J Nixon
• Joshua R. Noerr, FNP-C
• Joseph Anthony Novak, D.O.
• Nutrition With Elizabeth, LLC

• Physician Assistant in Brookville, PA
• Providers in Brookville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.