Tiffany Renae Nichols

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41704 Issued in TX

Practice address

13727 Noel Rd Ste 200
Dallas, TX 75240-1338

Phone

(972) 851-1022

NPI assigned

May 6, 2021

Last updated

May 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1629652664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 CHURCH RD",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760201442",
            "telephone_number": "440-328-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13727 NOEL RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401338",
            "telephone_number": "972-851-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "TIFFANY",
        "middle_name": "RENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "41704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "CubHub",
            "affiliation": "N",
            "address_1": "13727 Noel Rd Ste 200",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752401338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "CubHub",
            "affiliation": "N",
            "address_1": "13727 Noel Rd Ste 200",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752401338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joy Nichols, OT
• Kayla Nichols, PHD.
• Kelly Amanda Merritt Nichols, CRNA, DNP
• Lelia Lagrasse Nichols, NP
• Mabry Elizabeth Nichols
• Timothy D Nichols, MD
• Danielle Page Nicholson, OTR/L, OTD
• Sharon Nicholson, LBSW
• Janice Nici, PH.D.
• Brenda Joyce Nickel, PA-C

• Speech-Language Pathologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.