Individual provider Active NPI

Joshua Turner Nicholson, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1487916599
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101020091 Issued in MI
Practice address
245 Cherry St SE Ste 300
Grand Rapids, MI 49503
Phone
(616) 685-5050
Fax
(616) 685-8962
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101020091 MI Primary

Addresses

Primary practice location

245 Cherry St SE Ste 300
Grand Rapids, MI 49503

Mailing address

245 Cherry St SE Ste 300
Grand Rapids, MI 49503-4607
Phone (616) 685-5050

Other practice location 1

3400 Fleckenstein Rd
Flint, MI 48507-3042
Phone (810) 877-7370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160803002502 MI Practitioner - Physical Medicine and Rehabilitation 2264726918 Reassigns benefits to 1 organization
I20171012002720 CA Practitioner - Physical Medicine and Rehabilitation 2264726918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050

5060 Cascade Rd
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
15675CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 1, 2019 Accepting new patients
County of San Joaquin CurrentSince Jun 25, 2018 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Jun 25, 2018 Accepting new patients
County of San Joaquin CurrentSince Jun 25, 2018 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 1, 2019 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

220 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5576

245 Cherry St SE
Ste 300
Grand Rapids, MI 49503
Phone (616) 285-1377

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1487916599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034607",
            "telephone_number": "616-685-5050",
            "fax_number": "616-685-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-5050",
            "fax_number": "616-685-8962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Fleckenstein Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485073042",
            "country_code": "US",
            "telephone_number": "810-877-7370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JOSHUA",
        "middle_name": "TURNER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101020091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.