NPIMap

Organization Active NPI

Nichols Occupational Therapy PLLC

  • Occupational Therapist
  • Hollandale, MS
National Provider Identifier
1699430280
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NICHOLS OCCUPATIONAL THERAPY PLLC
Practice address
29 Susie B Law Rd
Hollandale, MS 38748-9710
Phone
(601) 850-7634
Fax
(360) 368-6227
NPI assigned
Nov 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Sarah Vitale Nichols, MSOT, OTR/LNPI 1285076307
Title
Occupational Therapist / Owner
Phone
(601) 850-7634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

29 Susie B Law Rd
Hollandale, MS 38748-9710

Mailing address

29 Susie B Law Rd
Hollandale, MS 38748-9710
Phone (601) 850-7634

Other identifiers 1

IdentifierTypeStateIssuer
02870784MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1699430280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SUSIE B LAW RD",
            "city": "HOLLANDALE",
            "state": "MS",
            "postal_code": "387489710",
            "telephone_number": "601-850-7634",
            "fax_number": "360-368-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SUSIE B LAW RD",
            "city": "HOLLANDALE",
            "state": "MS",
            "postal_code": "387489710",
            "telephone_number": "601-850-7634",
            "fax_number": "360-368-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLS OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "VITALE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "601-850-7634",
        "authorized_official_credential": "MSOT, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02870784",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollandale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.