Individual provider Active NPI

Nicole Nelson

  • Health Educator
  • Albany, NY
National Provider Identifier
1467897090
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
5463 Issued in NY
Practice address
326 S Pearl St
Albany, NY 12202-1914
Phone
(518) 449-0100
NPI assigned
May 9, 2013
Last updated
May 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X 5463 NY Primary

Addresses

Primary practice location

326 S Pearl St
Albany, NY 12202-1914

Mailing address

4 Atrium Dr
Suite 100
Albany, NY 12205-1441
Phone (518) 435-2740

Other identifiers 1

IdentifierTypeStateIssuer
5463OtherNYCERTFICATION

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
5463NYMDHealth Educator

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1467897090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATRIUM DR",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051441",
            "telephone_number": "518-435-2740",
            "fax_number": "518-649-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S PEARL ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021914",
            "telephone_number": "518-449-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NY",
            "license": "5463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTFICATION",
            "identifier": "5463",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.