Nicholson Urology LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

NICHOLSON UROLOGY LLC

Practice address

2751 Fort Amanda Rd
Lima, OH 45805-4805

Phone

(567) 529-9000

Fax

(567) 529-9001

NPI assigned

Nov 20, 2024

Organization subpart

Yes

Parent organization

WEST CENTRAL OHIO UROLOGICAL CENTERS OF EXCELLENCE, LLCAs reported in NPPES

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

Authorized official

Name

Kelly Elaine Bowers, BSN, RN

Title

Coo/Cco

Phone

(567) 529-9000

Specialties & licenses 1

Addresses

Other names 1

• Crossroads Urology Doing business as

Part of

Crossroads Urology

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• West Central Ohio Urological Centers of Excellence, LLC

  • Urology Physician
  • Lima, OH
  • NPI 1720798101
  NPPES parent name

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1669297941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 FORT AMANDA RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "567-529-9000",
            "fax_number": "567-529-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 FORT AMANDA RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "567-529-9000",
            "fax_number": "567-529-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLSON UROLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST CENTRAL OHIO UROLOGICAL CENTERS OF EXCELLENCE, LLC",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "COO/CCO",
        "authorized_official_telephone_number": "567-529-9000",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Billie Jo Nicely
• Abby Nichols
• Angelia Brooke Nichols
• Aubreyanna Nichols
• Tonja Lashay Nichols, LSW
• Craig Alan Nicholson, MD
• Stephanie Kay Nielsen, PHARM D
• James M Nieman, M.D.
• Alison Renee Niemeyer, DPM
• Tyler Jay Niese, C.N.P.

• Non-Pharmacy Dispensing Site in Lima, OH
• Providers in Lima, OH by specialty
• Non-Pharmacy Dispensing Site in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.