Individual provider Active NPI

Nichole Lynn Nygren, D.C.

  • Nutrition Chiropractor
  • Van Wert, OH
National Provider Identifier
1669526307
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2800 Issued in OH
Practice address
118 1/2 N Walnut St
Van Wert, OH 45891-1719
Phone
(419) 238-4387
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 2800 OH Primary

Addresses

Primary practice location

118 1/2 N Walnut St
Van Wert, OH 45891-1719

Mailing address

PO Box 27
Van Wert, OH 45891-0027
Phone (419) 238-4387

Other identifiers 1

IdentifierTypeStateIssuer
000000294842OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000551 OH Practitioner - Chiropractic 8123216611 Reassigns benefits to 1 organization
Practice locations: Van Wert, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

118 /2 N Walnut St
Van Wert, OH 45891-1719
Phone (419) 238-4387

118 /2N Walnut St
Van Wert, OH 45891-1719
Phone (419) 238-4387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2800OHMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nygren Chiropractic & Acupuncture LLC Nutrition CurrentSince Oct 25, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Nygren Family Chiropractic Nutrition PastSince Mar 1, 1999 Accepting new patients

Locations

118 N Walnut St
Van Wert, OH 45891
Phone (419) 238-4387

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1669526307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458910027",
            "telephone_number": "419-238-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 1/2 N WALNUT ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911719",
            "telephone_number": "419-238-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYGREN",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "OH",
            "license": "2800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000294842",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.