NPIMap

Individual provider Active NPI

Nicol Campbell Talbert, PA-C

  • Medical Physician Assistant
  • Gunnison, CO
National Provider Identifier
1033187026
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2297 Issued in CO
Practice address
130 E Virginia Ave
Gunnison, CO 81230-2246
Phone
(970) 641-0211
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10033 MN
Medical Physician Assistant 363AM0700X 2297 CO Primary

Addresses

Primary practice location

130 E Virginia Ave
Gunnison, CO 81230-2246

Mailing address

130 E Virginia Ave
Gunnison, CO 81230-2246
Phone (970) 641-0211

Other practice location 1

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060320000029 MN Practitioner - Physician Assistant 6608883418 Reassigns benefits to 4 organizations
I20100113000699 CO Practitioner - Physician Assistant 6608883418
I20250204002788 WI Practitioner - Physician Assistant 6608883418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.82 of 100Reported as group
Quality
9.1
Promoting interoperability
100
Improvement activities
0
Cost
43.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2297COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jul 1, 2025 Accepting new patients
The Duluth Clinic, LTD CurrentSince Sep 16, 2024 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Sep 16, 2024 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Pine Medical Center CurrentSince Sep 16, 2024 Accepting new patients
Pine Medical Center CurrentSince Sep 16, 2024 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Dec 2, 2024 Accepting new patients
Essentia Health Moose Lake CurrentSince Sep 16, 2024 Accepting new patients
Essentia Health Moose Lake CurrentSince Sep 16, 2024 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1033187026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E VIRGINIA AVE",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302246",
            "telephone_number": "970-641-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E VIRGINIA AVE",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302246",
            "telephone_number": "970-641-0211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALBERT",
        "first_name": "NICOL",
        "middle_name": "CAMPBELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10033",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gunnison, CO

Sources for this page

Verify at the official NPI Registry.