Individual provider Active NPI

Nicole Rose Light

  • Audiologist
  • Havertown, PA
National Provider Identifier
1679495535
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT007125 Issued in PA
Practice address
301 W Chester Pike Ste 101
Havertown, PA 19083-4530
Phone
(610) 446-6900
NPI assigned
Jul 29, 2026
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT007125 PA Primary

Addresses

Primary practice location

301 W Chester Pike Ste 101
Havertown, PA 19083-4530

Mailing address

301 W Chester Pike Ste 101
Havertown, PA 19083-4530

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT007125PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle ENT Alliance LLC CurrentSince Jul 28, 2026 Accepting new patients

Locations

301 W Chester Pike
Ste 101
Havertown, PA 19083
Phone (610) 446-6900

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1679495535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W CHESTER PIKE STE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W CHESTER PIKE STE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834530",
            "telephone_number": "610-446-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT007125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.