Active NPI
Nichole Dunwiddie
- Social Worker
- Traverse City, MI
National Provider Identifier
1437667904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801090746
- Practice address
- 4082 Evelyn St
Traverse City, MI 49686-3706 - Phone
- (231) 392-3069
- NPI assigned
- Jan 17, 2018
- Last updated
- Jan 17, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801090746 | MI | Primary |
Addresses
Primary practice location
4082 Evelyn St
Traverse City, MI 49686-3706
Mailing address
4082 Evelyn St
Traverse City, MI 49686-3706
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Old Town Psychological Services-Gaylord | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Child & Adolescent Psychologist
- Gaylord, MI
- NPI 1750659249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516147200000",
"number": "1437667904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4082 EVELYN ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496863706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4082 EVELYN ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496863706",
"telephone_number": "231-392-3069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNWIDDIE",
"first_name": "NICHOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-17",
"last_updated": "2018-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801090746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.