Eric R Nicely, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD0000019805 Issued in TN

Practice address

7557 Dannaher LN
Suite 230
Powell, TN 37849-3558

Phone

(865) 637-9431

Fax

(865) 637-8887

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Tennessee Urology Associates, PLLC

  • Urology Physician
  • Oak Ridge, TN
  • NPI 1669416442
  Medicare reassignment NPD
• Tennessee Urology Associates, PLLC

  • Urology Physician
  • Powell, TN
  • NPI 1932318284
  NPD

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1043210164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9724 KINGSTON PIKE",
            "address_2": "SUITE 800",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223347",
            "telephone_number": "865-690-0602",
            "fax_number": "865-690-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 DANNAHER LN",
            "address_2": "SUITE 230",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493558",
            "telephone_number": "865-637-9431",
            "fax_number": "865-637-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD0000019805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1669416442",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3106070",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI2260",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3106086",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084254",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Negus, PHARMD
• Amy Province Neil, ANP
• Debra A Nelson
• New Haven, LLC
• Tammy Y Newman, PA
• Erica Irwin Northern, MS
• Nicole Elizabeth Nugent, FNP-C
• Peter J Ochoa, MD
• Onyebuchi N Okereke, PT
• Seyi Adefunke Olaniyi, MD

• Urology Physician in Powell, TN
• Providers in Powell, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.