Active NPI
Karen Marie Nickols, C.M.T.
- Massage Therapist
- Sonora, CA
National Provider Identifier
1659761773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 31324
- Practice address
- 81 N Washington St
Suite C
Sonora, CA 95370-4727 - Phone
- (209) 406-4119
- NPI assigned
- Jan 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Reflexologist | 173C00000X | 31324 | CA | |
| Massage Therapist | 225700000X | 31324 | CA | Primary |
Addresses
Primary practice location
81 N Washington St
Suite C
Sonora, CA 95370-4727
Mailing address
81 N Washington St
Suite C
Sonora, CA 95370-4727
Phone (209) 406-4119
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31324 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422316800000",
"number": "1659761773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 N WASHINGTON ST",
"address_2": "SUITE C",
"city": "SONORA",
"state": "CA",
"postal_code": "953704727",
"telephone_number": "209-406-4119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 N WASHINGTON ST",
"address_2": "SUITE C",
"city": "SONORA",
"state": "CA",
"postal_code": "953704727",
"telephone_number": "209-406-4119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKOLS",
"first_name": "KAREN",
"middle_name": "MARIE",
"credential": "C.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-27",
"last_updated": "2015-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "CA",
"license": "31324",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "31324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.