Active NPI
Nicholas Ehrhardt
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1568259927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5189 - Phone
- (215) 707-7020
- NPI assigned
- Apr 21, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Physical Medicine & Rehabilitation Physician | 208100000X | MT237908 | PA |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5189
Mailing address
PO Box 1190
Lawrenceville, GA 30046-1190
Other practice location 1
665 Duluth Hwy Ste 401
Lawrenceville, GA 30046-4303
Phone (678) 312-0450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250529000391 | GA | Order and Referring Only - Internal Medicine | 9234658618 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT237908 | PA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1568259927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1190",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300461190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405189",
"telephone_number": "215-707-7020"
}
],
"practiceLocations": [
{
"address_1": "665 Duluth Hwy Ste 401",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300464303",
"country_code": "US",
"telephone_number": "678-312-0450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EHRHARDT",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-21",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "PA",
"license": "MT237908",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.