Individual provider Active NPI

Nicole Michelle Ward, RN, MSN, AGCNA-BC

  • Gerontology Clinical Nurse Specialist
  • San Diego, CA
National Provider Identifier
1518668151
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
4440 Issued in CA
Practice address
8695 Spectrum Center Blvd
San Diego, CA 92123-1489
Phone
(858) 499-4179
NPI assigned
Mar 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X 4440 CA Primary

Addresses

Primary practice location

8695 Spectrum Center Blvd
San Diego, CA 92123-1489

Mailing address

8695 Spectrum Center Blvd
San Diego, CA 92123-1489
Phone (858) 499-4179

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
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4440CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1518668151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8695 SPECTRUM CENTER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231489",
            "telephone_number": "858-499-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8695 SPECTRUM CENTER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231489",
            "telephone_number": "858-499-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "NICOLE",
        "middle_name": "MICHELLE",
        "credential": "RN, MSN, AGCNA-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "CA",
            "license": "4440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.