Individual provider Active NPI

Nichole A Wollf, CMA

  • Nurse's Aide
  • Smithville, TN
National Provider Identifier
1740413079
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
676921 Issued in TN
Practice address
254 Tiger Dr
Smithville, TN 37166-6812
Phone
(615) 597-7599
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 676921 TN Primary

Addresses

Primary practice location

254 Tiger Dr
Smithville, TN 37166-6812

Mailing address

254 Tiger Dr
Smithville, TN 37166-6812
Phone (615) 597-7599

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
Credentials
Certified Medical Assistant

State licenses

LicenseStateTypeSpecialty
676921TNMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1740413079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 TIGER DR",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371666812",
            "telephone_number": "615-597-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 TIGER DR",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371666812",
            "telephone_number": "615-597-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLF",
        "first_name": "NICHOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "TN",
            "license": "676921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.