Jonathon K Nicholson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301104162 Issued in MI

Practice address

1400 E 2ND St Ste 100
Defiance, OH 43512-9905

Phone

(419) 783-3226

NPI assigned

Jul 13, 2005

Last updated

Feb 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, OH, TX3 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 3

Specialty

Pediatric Medicine

Education

Medical College of Ohio, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
• FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4

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.

• Northwest Pediatric Specialists, LLC

  • Pediatrics Physician
  • Toledo, OH
  • NPI 1033709100
  Medicare reassignment NPD
• Beacon Kalamazoo Inc

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Medicare reassignment NPD
• Cirrusmd Medical Group of Delaware, P.a.

  • Family Medicine Physician
  • Denver, CO
  • NPI 1922664200

  OH

  Medicare reassignment NPD
• Cmdpn Medical Group of Texas, P.a.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1174082150
  Medicare reassignment NPD
• Beacon Kalamazoo Inc

  dba Borgess Family Medicine

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1144275934
  NPD
• Beacon Kalamazoo Inc

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
  • NPI 1518753441
  NPD
• Mercy Health - Defiance Hospital LLC

  dba Mercy Health - Defiance Hospital

  • General Acute Care Hospital
  • Defiance, OH
  • NPI 1629011234
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1538167572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST STE 100",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129905",
            "telephone_number": "419-783-3226",
            "fax_number": "989-356-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST STE 100",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129905",
            "telephone_number": "419-783-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JONATHON",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35080078",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301104162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010639",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald L Nash III
• Hope Neargarder
• Megan J Neville, LSW
• New Home Development Co., Inc.
• Terence R Newman, MD
• Emily Niese, FNP-C
• Lacey Niese
• Angela D Nihiser, LPN
• Nicole Nolan, RN
• Northeastern Local School District

• Pediatrics Physician in Defiance, OH
• Providers in Defiance, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.