James Mark Anthony Nicholson, LMT

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

019126 Issued in NY

Practice address

240 E 56TH St RM 4W
New York, NY 10022-3769

Phone

(917) 653-5090

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1881349355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BRUCKNER BLVD APT 3U",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104544577",
            "telephone_number": "917-653-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E 56TH ST RM 4W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223769",
            "telephone_number": "917-653-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Bruckner Blvd Apt 3U",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104544577",
            "country_code": "US",
            "telephone_number": "917-653-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JAMES",
        "middle_name": "MARK ANTHONY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NY",
            "license": "019126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james@evolved-fitness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 Bruckner Blvd Apt 3U",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104544577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james@evolved-fitness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 Bruckner Blvd Apt 3U",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104544577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Nichols, PH.D.
• Zachery Thomas Nichols, PHARMD
• Darryl Nicholson-Sansani, LCSW
• Brittany Nicholson
• Cameron Tyler Nicholson, PA-C
• Lauren Nicholson
• Ronald Nicholson
• Susan Nicholson, M.D.
• Tara Nicholson, ACNP
• Terriann Nicholson, MD

• Mechanotherapist in New York, NY
• Providers in New York, NY by specialty
• Mechanotherapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.