Active NPI
Joan E Song-Nichols, DO
- Family Medicine Physician
- Sacaton, AZ
National Provider Identifier
1639159593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2960
- Practice address
- 483 W. Seed Farm Rd.
Sacaton, AZ 85147 - Phone
- (602) 528-1200
- Fax
- (602) 528-1255
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2960 | AZ | Primary |
Addresses
Primary practice location
483 W. Seed Farm Rd.
Sacaton, AZ 85147
Mailing address
PO Box 38
Sacaton, AZ 85147
Phone (602) 528-1200
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2960 | AZ | MD | Occupational Therapy Assistant |
Interoperability endpoints
- joan.song-nichols.1@14940.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1639159593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38",
"city": "SACATON",
"state": "AZ",
"postal_code": "85147",
"telephone_number": "602-528-1200",
"fax_number": "602-528-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 W. SEED FARM RD.",
"city": "SACATON",
"state": "AZ",
"postal_code": "85147",
"telephone_number": "602-528-1200",
"fax_number": "602-528-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG-NICHOLS",
"first_name": "JOAN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "2960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacaton, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.