Scott Crandall Nicholson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT-030789 Issued in AZ

Practice address

1300 S Milton Rd
#206
Flagstaff, AZ 86001-7302

Phone

(928) 774-8407

NPI assigned

Feb 16, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1821537390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E CRESTVIEW AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014759",
            "telephone_number": "928-853-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S MILTON RD",
            "address_2": "#206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017302",
            "telephone_number": "928-774-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SCOTT",
        "middle_name": "CRANDALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-030789",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Desabah Nez
• Erin Kim Nguyen
• Vy Nguyen, OTD
• Benjamin Nicholas
• Scott Nichols, DVM
• Cooper Nickels, DO
• Janet Marie Nicks, RN, CNOR, RNFA, NP-C
• Bradley Robert Nicol, MD
• Jeremy Nielsen, M.D.
• Callie Rae Niemann, AUD

• Massage Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.