GARY L NICHOLSON (NPI# 1407806474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407806474 |
| Entity Type | Individual |
| Full Name | GARY L NICHOLSON |
| Credential | M.D. |
| Practice Address |
3120 Governors Place Blvd Kettering OH 45409-1328 |
| Mailing Address |
2264 Berrycreek Dr Kettering OH 45440-2621 |
| Practice Telephone | 9372931622 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
35034705 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0330270 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780715383 | Gary Warner Nicholson | Specialist/Technologist | Athletic Dept Pacific Lutheran University, Tacoma, WA 98447-0003 | 2007-03-08 |
| 1629145768 | Gary J Nicholson | Obstetrics & Gynecology | 161 Riverside Dr, Suite 109, Binghamton, NY 13905-4176 | 2006-11-30 |
| Street Address |
3120 GOVERNORS PLACE BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45409-1328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427050798 | Maureen Crossman | Pharmacist | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2005-06-01 |
| 1225364714 | Thomas Alexander Rhone | Pharmacist | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2009-10-19 |
| 1790995587 | Compunet Clinical Laboratories, LLC | Clinical Medical Laboratory | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2007-05-23 |
| 1568686087 | Greater Dayton Cancer Center Pharmacy | Pharmacy | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2007-04-13 |
| 1992714018 | Dayton Oncology & Hematology, Pa | Specialist | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2006-08-07 |
| 1760432769 | Satheesh K. Kathula | Internal Medicine | 3120 Governors Place Blvd, Kettering, OH 45409 | 2006-05-11 |
| 1205832730 | Manish R Sheth | Internal Medicine | 3120 Governors Place Blvd, Kettering, OH 45409-1328 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487276457 | Matthew R Schaeffer | Surgery | 128 E Apple St., Wche 7th Floor, Dayton, OH 45409 | 2020-05-13 |
| 1699237545 | Elizabeth Joan Hudson | Student in an Organized Health Care Education/Training Program | 1 Wyoming Street Miami Valley Hospital Medical Educatio, Dayton, OH 45409 | 2019-04-01 |
| 1760941066 | Courtney Lyn Johnson | Surgery | 128 East Apple Street, Wche 7th Floor, Dayton, OH 45409 | 2019-03-16 |
| 1477057529 | Adam Joseph Langer | Student in an Organized Health Care Education/Training Program | 128 E. Apple St Suite 3800, Wright State University Dept of Ob/gyn, Dayton, OH 45409 | 2018-03-22 |
| 1659870939 | Timothy Wall | Student in an Organized Health Care Education/Training Program | 128 East Apple St., 2nd Floor, Dayton, OH 45409 | 2018-02-01 |
| 1124551411 | Adam Schmerge Deardorff | Student in an Organized Health Care Education/Training Program | 30 E Apple St Ste 6257, Dayton, OH 45409 | 2017-04-04 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1689054223 | Jessica Ezinne Ugwu | Family Medicine | 30 E Apple St., Suite Nw 3300, Dayton, OH 45409 | 2015-06-08 |
| 1679983084 | Jude Anneryan Cohen | Registered Nurse | 1200 W. Dorothy Lane, Southdale Elementary School, Kettering, OH 45409 | 2014-05-07 |
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| Find all providers in zip 45409 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558540674 | Ashantice Kenyana Higgins | Internal Medicine | 3700 Southern Blvd, Suite 401, Kettering, OH 45429-1226 | 2007-10-25 |
| 1457341760 | Alejandro R Calvo | Internal Medicine | 3700 Southern Blvd Ste 401, Kettering, OH 45429-1265 | 2005-10-27 |
| 1568855104 | Alliance Physicians Inc | Internal Medicine | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2015-03-06 |
| 1831451129 | Susan Bal | Internal Medicine | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2012-06-12 |
| 1275815672 | Alliance Physician Inc | Internal Medicine | 3737 Southern Blvd, Suite 3200, Kettering, OH 45429-1286 | 2011-09-13 |
| 1568743292 | Alliance Physician Inc | Internal Medicine | 3533 Southern Blvd, Suite 3750, Kettering, OH 45429-1264 | 2011-09-08 |
| 1255612974 | Alliance Physician Inc | Internal Medicine | 3535 Southern Blvd, 4th Floor, Kettering, OH 45429-1221 | 2011-09-08 |
| 1295929875 | Emily Jo Franks | Internal Medicine | 3700 Southern Blvd Ste 401, Kettering, OH 45429-1226 | 2007-08-28 |
| 1356464614 | Brandon J Cutler | Internal Medicine | 3700 Southern Blvd Ste 401, Kettering, OH 45429-1226 | 2007-04-09 |
| 1760432769 | Satheesh K. Kathula | Internal Medicine | 3120 Governors Place Blvd, Kettering, OH 45409 | 2006-05-11 |
| Find all providers in KETTERING | ||||
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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.