Hannah Nicholson

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AG01240073 Issued in NC

Practice address

4503 Main St Ste 1
Shallotte, NC 28470-4583

Phone

(910) 754-2273

Fax

(910) 754-2254

NPI assigned

Jan 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Interoperability endpoints

• Direct secure messaging: hannahnicholson@sws.allscriptsdirect.net

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.

• Raleigh Durham Medical Group, PA

  • Family Medicine Physician
  • Shallotte, NC
  • NPI 1720458326
  NPD

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1073375481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 BONNIE B LN",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284700016",
            "telephone_number": "910-736-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 MAIN ST STE 1",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704583",
            "telephone_number": "910-754-2273",
            "fax_number": "910-754-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "AG01240073",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "AG01240073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• National Vision, Inc.
• Mallory Genine Neill Rogers, LCMHCA, LCAS
• Heather Lyndsay Ness, PT
• Erica Nethercutt, FNP-BC
• Katherine Hang Nguyen
• North Carolina CVS Pharmacy LLC
• Novant Health Employer Solutions, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group Coastal Region, LLC
• Novant Health Medical Group, LLC

• Adult Health Nurse Practitioner in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.