Active NPI
Timothy Lee Nicholl, DC
- Chiropractor
- West Sacramento, CA
National Provider Identifier
1760754121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 32059
- Practice address
- 2210 Lake Washington Blvd
#130
West Sacramento, CA 95691-6415 - Phone
- (916) 594-7630
- NPI assigned
- Feb 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 32059 | CA | Primary |
Addresses
Primary practice location
2210 Lake Washington Blvd
#130
West Sacramento, CA 95691-6415
Mailing address
2210 Lake Washington Blvd
#130
West Sacramento, CA 95691-6415
Phone (916) 594-7630
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32059 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1760754121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 LAKE WASHINGTON BLVD",
"address_2": "#130",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956916415",
"telephone_number": "916-594-7630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2210 LAKE WASHINGTON BLVD",
"address_2": "#130",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956916415",
"telephone_number": "916-594-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLL",
"first_name": "TIMOTHY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-01",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "32059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.