NICHOLE CHAUNTELLE WILSON (NPI# 1740730811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740730811 |
| Entity Type | Individual |
| Full Name | NICHOLE CHAUNTELLE WILSON |
| Practice Address |
150 Shoup Ave Idaho Falls ID 83402-3657 |
| Practice Telephone | 2083594778 |
| Mailing Telephone | 2083594778 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902431885 | Nichole Parker Wilson | Nurse Practitioner | 37 Pineville Blvd, Clayton, NC 27527-9355 | 2020-03-11 |
| 1225418114 | Nichole Wilson | Social Worker | 24500 Center Ridge Rd Ste 395, Westlake, OH 44145-5631 | 2015-06-04 |
| 1861006025 | Nichole Wilson | Counselor | 615 W Civic Center Dr Ste 200, Santa Ana, CA 92701-4052 | 2020-09-04 |
| 1881186120 | Nichole Wilson | Nurse Practitioner | 7404 5th Ave, Brooklyn, NY 11209-2704 | 2018-06-02 |
| 1396025052 | Nichole Rae Wilson | Pharmacist | 10050 Glenwood Ave, Raleigh, NC 27617-8436 | 2011-08-25 |
| Street Address |
150 SHOUP AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275669152 | Idaho Dept of Health & Welfare Region 7 Amh Psr If | Clinic/Center | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2007-02-26 |
| 1639733256 | Michaelina S Page | Registered Nurse | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2019-04-29 |
| 1013489285 | Maria Rodriguez-moncada | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-12-27 |
| 1437626124 | Elizabeth Rae Lagazo | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-10-31 |
| 1942784756 | Robert Creighton Shumway | Physician Assistant | 150 Shoup Ave, #170, Idaho Falls, ID 83402 | 2018-09-18 |
| 1023507977 | Zachary Wixom | Counselor | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-05-07 |
| 1841723822 | Jennifer Lebel | Registered Nurse | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-04-06 |
| 1194264127 | Timothy Mchugh | Physician Assistant | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-02-23 |
| 1700331279 | Kayla Schroeder | Speech-Language Pathologist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-08-24 |
| 1306296488 | Marie Sheranian | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| 1073974515 | Carly Kay Powell | Developmental Therapist | 150 Shoup Avenue, Idaho Falls, ID 83402 | 2016-03-11 |
| 1013489285 | Maria Rodriguez-moncada | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-12-27 |
| 1437626124 | Elizabeth Rae Lagazo | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-10-31 |
| 1427536614 | Peterson Therapy Services, Inc | Developmental Therapist | 545 Lincoln Dr, Idaho Falls, ID 83401 | 2018-07-31 |
| 1265959498 | Trena Kirsten Stoneman | Developmental Therapist | 150 Shoup Avenue, Idaho Falls, ID 83401 | 2017-08-28 |
| 1306296488 | Marie Sheranian | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-06-20 |
| 1154782365 | Sandra Cummings | Developmental Therapist | 150 Shoup Ave, Suite 19, Idaho Falls, ID 83402-3657 | 2016-03-15 |
| 1093175473 | Kathleen Kunkel | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-02-29 |
| 1760842140 | Stephanie Olson | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-02-29 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on NICHOLE CHAUNTELLE WILSON.
| 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.