Individual provider Active NPI

Nichole Marie Phillips, LVN

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1881430593
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
272481 Issued in CA
Practice address
539 N Van Ness Ave
Fresno, CA 93728-3419
Phone
(559) 266-9581
NPI assigned
Jul 2, 2024
Last updated
Nov 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 272481 CA Primary

Addresses

Primary practice location

539 N Van Ness Ave
Fresno, CA 93728-3419

Mailing address

4245 N Durango Ave
Fresno, CA 93722-0451
Phone (559) 776-5787

Other practice location 1

2615 E Clinton Ave
Fresno, CA 93703-2223
Phone (559) 225-6100 ext. 6353

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

State licenses

LicenseStateTypeSpecialty
272481CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1881430593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 N DURANGO AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937220451",
            "telephone_number": "559-776-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-266-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 E Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937032223",
            "country_code": "US",
            "telephone_number": "559-225-6100 x6353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "272481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2024; 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.