Individual provider Active NPI

Nannette Nicholson, PH.D.

  • Audiologist
  • Little Rock, AR
National Provider Identifier
1508088055
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
255 Issued in AR
Practice address
2801 S University Ave - Ualr
Suite 600 University Plaza
Little Rock, AR 72204-1000
Phone
(501) 569-8909
Fax
(501) 569-3157
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 255 AR Primary

Addresses

Primary practice location

2801 S University Ave - Ualr
Suite 600 University Plaza
Little Rock, AR 72204-1000

Mailing address

2801 S University Ave - Ualr
Suite 600 University Plaza
Little Rock, AR 72204-1000
Phone (501) 569-8909

Other identifiers 1

IdentifierTypeStateIssuer
170942720MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181231001226 FL Practitioner - Qualified Audiologist 4385827369 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
255ARMDAudiologist
1941KSMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Mar 30, 2023 Accepting new patients
University of Arkanas for Medical Sciences Past Accepting new patients
University of Arkanas for Medical Sciences Audiologist Past Accepting new patients
Ku Health Partners, Inc Audiologist Past Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

3200 S University Dr
Fl 1
Davie, FL 33328

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1508088055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S UNIVERSITY AVE - UALR",
            "address_2": "SUITE 600 UNIVERSITY PLAZA",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041000",
            "telephone_number": "501-569-8909",
            "fax_number": "501-569-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S UNIVERSITY AVE - UALR",
            "address_2": "SUITE 600 UNIVERSITY PLAZA",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041000",
            "telephone_number": "501-569-8909",
            "fax_number": "501-569-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "NANNETTE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AR",
            "license": "255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170942720",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.