Mary Ellen Nichols, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F381231 Issued in NY

Practice address

1555 Long Pond Rd
Department of Pediatrics
Rochester, NY 14626-4122

Phone

(585) 368-4012

Fax

(585) 368-4019

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Ellen Capece Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1649203555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-368-4012",
            "fax_number": "585-368-4019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131090",
            "country_code": "US",
            "telephone_number": "315-359-2660",
            "fax_number": "315-359-2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARY ELLEN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02573513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "CAPECE",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Susan Nichols, RPA-C
• Justine Joy Nichols
• Kimberly Sue Nichols, P.T, ATC
• Lisa Nichols
• Maria Nichols, CRPA
• Jacqueline Elizabeth Nicholson, L.P.N
• Katherine Nicholson
• Susan Nicholson
• Jean L Nickels, MD
• Mark Nickels, MD

• Pediatric Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.