MR. JOHN DAVID NICHOLSON JR. (NPI# 1790095933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790095933 |
| Entity Type | Individual |
| Full Name | MR. JOHN DAVID NICHOLSON JR. |
| Credential | PA |
| Practice Address |
111 N 49th St Philadelphia PA 19139-2718 |
| Practice Telephone | 2154712488 |
| Practice Fax Number | 2154712897 |
| Mailing Telephone | 2154712488 |
| Mailing Fax Number | 2154712897 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA001440L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518243641 | John M Nicholson | Pharmacist | 260 W New Circle Rd, Lexington, KY 40505-1426 | 2011-11-03 |
| 1548550833 | John Richard Nicholson IIi | Internal Medicine | 201 Sivley Rd Sw Ste 200, Huntsville, AL 35801-5177 | 2011-04-08 |
| 1023176625 | John Louis Nicholson | Clinic/Center | 715 Altos Oaks Dr, Los Altos, CA 94024-5402 | 2006-12-05 |
| 1497723795 | John Nicholson | Internal Medicine | 728 Hartness Rd, Statesville, NC 28677-3425 | 2006-03-10 |
| 1316448459 | John Kirkwood Nicholson | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2018-02-23 |
| 1568819449 | John Forrest Nicholson IIi | Nurse Anesthetist, Certified Registered | 129 N Washington St, Sumter, SC 29150-4949 | 2016-05-19 |
| 1184859100 | John E Nicholson | Dentist | 187 New Hackensack Rd, Wappingers Falls, NY 12590-1726 | 2009-05-19 |
| 1205021516 | John Henry Nicholson | Family Medicine | 169 Delaware Ave, Palmerton, PA 18071-1708 | 2007-09-10 |
| 1699872101 | John Dailey Nicholson | Surgery | 5100 W Taft Rd, Suite 4a, Liverpool, NY 13088 | 2006-09-19 |
| 1336152842 | John F Nicholson | Family Medicine | 329 S Pleasant Avenue, Somerset, PA 15501 | 2006-08-14 |
| Street Address |
111 N 49TH ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19139-2718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851390561 | Corecare Behavioral Health | Rehabilitation, Substance Use Disorder Unit | 111 N 49th St, Philadelphia, PA 19139-2718 | 2005-07-15 |
| 1700360724 | Chinyere Adama Enyia | Nurse Practitioner | 111 N 49th St, Philadelphia, PA 19139-2718 | 2018-09-17 |
| 1891014783 | West Philadelphia Community Mental Health Consortium | Early Intervention Provider Agency | 111 N 49th St, Early Intervention Program, Philadelphia, PA 19139-2718 | 2010-05-18 |
| 1275787731 | Bella Yampolsky | Physician Assistant | 111 N 49th St, Philadelphia, PA 19139-2718 | 2008-11-11 |
| 1558520841 | Corecare Behavioral Health Management, Inc. | Clinic/Center | 111 N 49th St, Philadelphia, PA 19139-2718 | 2008-06-03 |
| 1861676801 | Erica M Brendel | Psychiatry & Neurology | 111 N 49th St, Philadelphia, PA 19139-2718 | 2007-12-27 |
| 1891974424 | Stephen Karafelli | Social Worker | 111 N 49th St, Philadelphia, PA 19139-2718 | 2007-10-31 |
| 1699963736 | First Home Care Corporation | Community/Behavioral Health | 111 N 49th St, 1st Floor, Philadelphia, PA 19139-2718 | 2007-10-12 |
| 1477676328 | Fred Baurer | Psychiatry & Neurology | 111 N 49th St, Philadelphia, PA 19139-2718 | 2007-04-07 |
| 1841312196 | Kambeze Banan Etemad | Psychiatry & Neurology | 111 N 49th St, Philadelphia, PA 19139-2718 | 2007-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1770192890 | Michael Pappano LLC | Social Worker | 31 South 51st St, Philadelphia, PA 19139 | 2020-07-24 |
| 1912419581 | Christina Lipuma | Dietitian, Registered | 5210 Haverford Ave, Philadelphia, PA 19139 | 2017-11-03 |
| 1538515564 | New Vitae Inc | Public Health or Welfare | 27 S 55th Street, Philadelphia, PA 19139 | 2016-05-09 |
| 1982058681 | Phyllis Mwaura | In Home Supportive Care | 5338 Vine Street, Basement, Philadelphia, PA 19139 | 2016-04-19 |
| 1861879322 | Barbara Joette Hegarty | Counselor | 4508 Chestnut Street, Philadelphia, PA 19139 | 2015-05-04 |
| 1336533454 | Julie Magallanes-montone | Family Medicine | 5201 Haverford Avenue, Philadelphia, PA 19139 | 2015-03-26 |
| 1134494909 | The Children's Hospital of Philadelphia | Pediatrics | 4865 Market Street, Philadelphia, PA 19139 | 2012-03-13 |
| 1467757443 | Nouman Bashir | Dentist | 5139 Chestnut Stree, Philadelphia, PA 19139 | 2011-01-21 |
| 1720396732 | Serena Denise Johnson | Contractor | 5151a Walnut Street, Philadelphia, PA 19139 | 2010-09-24 |
| Find all providers in zip 19139 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19139 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.