Nicosia Enterprises LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

NICOSIA ENTERPRISES LLC

Practice address

13674 Arizona Dr
Tyler, TX 75707-6806

Phone

(903) 566-6816

Fax

(972) 268-6014

NPI assigned

Dec 15, 2013

Organization subpart

No

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

Authorized official

Name

Chanda Lea Nicosia, LSA

Title

Owner

Phone

(903) 566-6816

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1387065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1821419011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13674 ARIZONA DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757076806",
            "telephone_number": "903-566-6816",
            "fax_number": "972-268-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13674 ARIZONA DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757076806",
            "telephone_number": "903-566-6816",
            "fax_number": "972-268-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOSIA ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-15",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "NICOSIA",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-566-6816",
        "authorized_official_credential": "LSA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00471",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jean Osina Nichols, M.D.
• Savannah Joy Mariano Nichols, MD
• Lauren Christine Nicholson, BSN, RN, CRNI
• Heath Nickel, PHARMD
• Gina M Nickels-Nelson, FNP
• Chanda Lea Nicosia, CSFA/LSA
• Rosie M Niebuhr
• Kurt Nielsen, MD
• Jeffrey M Niemann, MD
• Nightingale Provider Services Inc. (Nightingale Home Health Agency)

• Surgical Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.