Nicholas Gaultney, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

859829 Issued in TX

Practice address

14603 Huebner Rd Ste 3505
San Antonio, TX 78230-5469

Phone

(210) 985-1900

Fax

(210) 985-1905

NPI assigned

Jun 8, 2016

Last updated

Apr 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canvas Mental Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Antonio, TX
  • NPI 1154085611
  NPD Authorized official
• E P Ted Williams Mdpa

  dba Genesis Behavioral Health

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1518190859
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1912356197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591245",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782590112",
            "telephone_number": "210-985-1900",
            "fax_number": "210-985-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14603 HUEBNER RD STE 3505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305469",
            "telephone_number": "210-985-1900",
            "fax_number": "210-985-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULTNEY",
        "first_name": "NICHOLAS",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "859829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Charles Gatlin, LPC
• Steven Beau Gatlin, A.U.D.
• Victoria Nichole Gatlin
• Lula Gatling
• Michael Blaine Gaub, MD
• Megan Michelle Gauntt, NNP
• Brenda Gaura, PT
• Adriana Gauthier, COTA/L
• Brandon Allen Gauthier
• Charles D. Gauthier, PA-C

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.