Nicole Lee Clegg, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.25505 Issued in SC

Practice address

93 N Main St
Hilton Head Island, SC 29926-6613

Phone

(843) 681-3777

NPI assigned

Oct 22, 2021

Last updated

Apr 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EHFHBD
• FHIR API: https://fhir4.healow.com/fhir/r4/EHFHBD/Endpoint/EHFHBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Main Street Medical PC

  • Multi-Specialty Clinic/Center
  • Hilton Head, SC
  • NPI 1922192194
  Medicare reassignment NPD

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1033873450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2153 BLAKERS BLVD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097805",
            "telephone_number": "740-238-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 N MAIN ST",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299266613",
            "telephone_number": "843-681-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEGG",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN.25505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare J Charles Lisw-CP LLC
• Ella Karen Clark, PA
• Kristen Ann Clark, PA-C
• Matthew Michael Clark, PT
• Kristofer Clarke
• Clemson Sports Medicine and Rehabilitation (Clemson PT & Spine Rehab)
• Clemson Sports Medicine and Rehabilitation Inc (Island Physical Therapy)
• Clinical Associates of Hilton Head,P.C
• Coastal Anesthesiology Associates, LLC
• Coastal Gastroenterology PC

• Family Nurse Practitioner in Hilton Head Island, SC
• Providers in Hilton Head Island, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.