Active NPI
Nolan Uhlich, PA-C
- Physician Assistant
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA220563
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (904) 953-2000
- NPI assigned
- Jan 12, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | FL | ||
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA220563 | OR | Primary |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other practice location 1
1995 Clairmont Rd
Decatur, GA 30033-3407
Phone (470) 601-7810
Other practice location 2
300 N Graham St Ste 125
Portland, OR 97227-1683
Phone (503) 413-3714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-1122
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.62 of 100
- Quality
- 77.21
- Promoting interoperability
- 99.06
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA220563 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Current | Accepting new patients | |
| First Class Healthcare LLC | Past | Accepting new patients |
Locations
25050 SE Stark St
Ste 265
Gresham, OR 97030
Phone (503) 413-2005
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
300 N Graham St
Ste 125
Portland, OR 97227
Phone (503) 413-3714
Organizations & group practices 2
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.
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
-
- Health Maintenance Organization
- Lawrenceville, GA
- NPI 1639891765
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1083203491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
}
],
"practiceLocations": [
{
"address_1": "1995 Clairmont Rd",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "GA",
"postal_code": "300333407",
"country_code": "US",
"telephone_number": "470-601-7810",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 N Graham St Ste 125",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271683",
"country_code": "US",
"telephone_number": "503-413-3714",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UHLICH",
"first_name": "NOLAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA220563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.
- 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.