Active NPI
Ryan Patrick Nicholas, OTR
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1669723870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003499A
- Practice address
- 303 N Hurstbourne Pkwy
Suite 200
Louisville, KY 40222-5185 - Phone
- (502) 412-5847
- NPI assigned
- Sep 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31003499A | IN | Primary |
Addresses
Primary practice location
303 N Hurstbourne Pkwy
Suite 200
Louisville, KY 40222-5185
Mailing address
340 Topaz St
Mitchell, IN 47446-6662
Phone (812) 583-7824
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 |
|---|---|---|---|
| 31003499A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1669723870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 TOPAZ ST",
"city": "MITCHELL",
"state": "IN",
"postal_code": "474466662",
"telephone_number": "812-583-7824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N HURSTBOURNE PKWY",
"address_2": "SUITE 200",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402225185",
"telephone_number": "502-412-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "RYAN",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-27",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003499A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.