Individual provider Active NPI

Nicole Alice Nock, LPN

  • Licensed Practical Nurse
  • Dayton, OH
National Provider Identifier
1740306752
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN 107175 Issued in OH
Practice address
112 Dale Ridge Drive
Dayton, OH 45458-2358
Phone
(937) 684-7663
Fax
(888) 213-6615
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 107175 OH Primary

Addresses

Primary practice location

112 Dale Ridge Drive
Dayton, OH 45458-2358

Mailing address

112 Dale Ridge Drive
Dayton, OH 45458-2358
Phone (937) 684-7663

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

LicenseStateTypeSpecialty
PN 107175OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1740306752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 DALE RIDGE DRIVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454582358",
            "telephone_number": "937-684-7663",
            "fax_number": "888-213-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DALE RIDGE DRIVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454582358",
            "telephone_number": "937-684-7663",
            "fax_number": "888-213-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOCK",
        "first_name": "NICOLE",
        "middle_name": "ALICE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 107175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.