Eleisha Jean Nickoles, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

12971 Issued in TN

Practice address

1413 Russell Ave
Jefferson City, TN 37760-2562

Phone

(865) 471-5525

Fax

(865) 471-5526

NPI assigned

Oct 12, 2006

Last updated

Aug 19, 2026By 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 TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eleisha J Nickoles, DDS, PLLC

  • Dental Clinic/Center
  • Wheeling, WV
  • NPI 1578273165
  NPD Authorized official
• Rural Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newport, TN
  • NPI 1962443697
  Medicare reassignment

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1053400309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LEEPER OVERLOOK",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377255073",
            "telephone_number": "865-471-5525",
            "fax_number": "865-471-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 RUSSELL AVE",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602562",
            "telephone_number": "865-471-5525",
            "fax_number": "865-471-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOLES",
        "first_name": "ELEISHA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cortney Myers
• Nancy Myers
• Thomas Harrison Newcomb, DC
• Jennifer Nichols, PHARMD
• Wanda Kay Agent Nicholson, PT
• Sheri Agatha Nsamenang, M.S.
• Sheila Ann Olsen, FNP
• Optimus Health Center, Inc. (St. Luke's Therapy Services)
• Overcome Adversity, PLLC
• Fiorello Erico Pacia Jr., PT

• Dentist in Jefferson City, TN
• Providers in Jefferson City, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.