Jennifer Nicholson, MOT, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

114919 Issued in TX

Practice address

1073 Maverick Dr
Allen, TX 75013-2882

Phone

(504) 650-5366

NPI assigned

Feb 22, 2016

Last updated

Jul 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Diamondback Medical Solutions PLLCGroup PAC ID 8527407881, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Diamondback Medical Solutions PLLC

  • Family Nurse Practitioner
  • McKinney, TX
  • NPI 1275383655
  Medicare reassignment Care Compare group NPD
• Diamondback Medical LLC

  • Chiropractor
  • McKinney, TX
  • NPI 1700437845
  NPD

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1467811232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 MAVERICK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 MAVERICK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132882",
            "telephone_number": "504-650-5366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Alliance Blvd",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750935323",
            "country_code": "US",
            "telephone_number": "469-814-2556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JENNIFER",
        "credential": "MOT, OTR/L, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jitpisot Jumnongjit Nguyen
• Manh Nguyen
• Nicole Kieu Nguyen
• Rachel Nguyen
• Steven Nguyen
• Mary Trotty Nickson, PH.D.
• Nicole C Hodge MD PA
• Michael John Niederkorn, O.D.
• Michelle Holman Nietert, LPC
• Dipali Kedar Nigudkar, DMD

• Occupational Therapist in Allen, TX
• Providers in Allen, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.