Alissa Lauren Nickerson, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

DA10810 Issued in AZ

Practice address

1920 E Cambridge Ave Ste 201
Phoenix, AZ 85006-1462

Phone

(602) 933-3277

Fax

(602) 933-4326

NPI assigned

Aug 14, 2017

Sex

Female

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

Enrolled in AZ

Enrollment records 1

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 and National Provider Directory roles.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1679703441
  NPD

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1912423799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE STE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061462",
            "telephone_number": "602-933-3277",
            "fax_number": "602-933-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "ALISSA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA10810",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-001637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Nichols, PHARMD
• Travis Nichols, PH.D.
• Alexandra Helene Nicholson, M.D.
• Tamara Gerry Nicholson, DPT
• Austin Lee Nickell, MD
• Dustin Duane Nickerson, FNP-C
• Lea Nickolas, FNP-BC
• Noelle M Nicolas, SLP
• Kyrie Jae Nicolds, PA-C
• Nicole Lazorwitz PSYD LLC

• Audiologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Audiologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.