Benjamin Charles Nick, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

11023584A Issued in IN

Practice address

1120 W. Michigan Street
Gatch Hall CL 365
Indianapolis, IN 46202

Phone

(317) 274-0267

NPI assigned

Mar 21, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753488000000",
    "number": "1720848278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W. 14TH ST., INDIANAPOLIS, IN 46202",
            "address_2": "OFFICE 6065",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972",
            "telephone_number": "317-274-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W. MICHIGAN STREET",
            "address_2": "GATCH HALL CL 365",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-274-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICK",
        "first_name": "BENJAMIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2025-07-26",
        "certification_date": "2025-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11023584A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicholson
• Jessica L Nicholson, NP
• Lindsey Nicholson, OD
• Raychell Nicholson, RBT
• Sarah Elizabeth Nicholson, DNP, NNP
• Pamela M Nickell, NP
• Patshawna Faith Nickeo, MSW, LSW
• Margaret Clare Nickerson
• Victoria Taite Nickerson
• Latrice D Nicks

• Student in an Organized Health Care Education/Training Program in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2025; 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.