Individual provider Active NPI

Paul Nimchick

  • Specialist
  • West Springfield, MA
National Provider Identifier
1982730073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AH 1208 AT Issued in MA
Practice address
71 Craig Dr Apt A8
West Springfield, MA 01089-1432
Phone
(413) 737-0130
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AH 1208 AT MA Primary

Addresses

Primary practice location

71 Craig Dr Apt A8
West Springfield, MA 01089-1432

Mailing address

71 Craig Dr Apt A8
West Springfield, MA 01089-1432
Phone (413) 737-0130

Other identifiers 1

IdentifierTypeStateIssuer
AH 1208 ATOtherMAATHLETIC TRAINER

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
AH 1208 ATMAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982730073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CRAIG DR APT A8",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891432",
            "telephone_number": "413-737-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CRAIG DR APT A8",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891432",
            "telephone_number": "413-737-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMCHICK",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "AH 1208 AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "AH 1208 AT",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.