Luke Nicholson

Primary specialty

DentistTaxonomy code 122300000X

License

10269 Issued in AZ

Practice address

33C Sidney CT
Pittsburgh, PA 15203-2177

Phone

(740) 275-1322

NPI assigned

Feb 9, 2016

Last updated

Jun 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• South Dakota Dental Anesthesia LLC

  • Dental Clinic/Center
  • Sioux Falls, SD
  • NPI 1700724994
  NPD Authorized official
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1720446461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33C SIDNEY CT",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032177",
            "telephone_number": "740-275-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33C SIDNEY CT",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032177",
            "telephone_number": "740-275-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LUKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-09",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10269",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Marie Nicholson, CRNP
• Joanne B Nicholson, MA CCC-SLP
• Jodie Lynn Nicholson
• Katherine Nicholson
• Kristina Joy Nicholson, MD
• Beth M Nickel, PA-C
• Patton V Nickell, MD
• Beverly A. Nickelson, CRNA
• Mary Sue Nickl
• Alyssa Nicole Nicklas, RN

• Dentist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.