Individual provider Active NPI

Francis William Nicholson, PEER SPECIALIST

  • Specialist
  • Jackson, WY
National Provider Identifier
1497070742
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
640 E Broadway
Jackson, WY 83001-1868
Phone
(307) 732-1161
Fax
(307) 732-1191
NPI assigned
Mar 30, 2010
Last updated
Mar 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

640 E Broadway
Jackson, WY 83001-1868

Mailing address

PO Box 1868
Jackson, WY 83001-1868
Phone (307) 732-1161

Other names 1

  • Bill Nicholson Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health & Recovery Services of Jackson Hole PastSince Jun 1, 2014 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.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1497070742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1868",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011868",
            "telephone_number": "307-732-1161",
            "fax_number": "307-732-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011868",
            "telephone_number": "307-732-1161",
            "fax_number": "307-732-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "FRANCIS",
        "middle_name": "WILLIAM",
        "credential": "PEER SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "NICHOLSON",
            "credential": "PEER SPECIALIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.