Individual provider Active NPI

James E. Nicholson

  • Emergency Medicine Physician
  • Dunn, NC
National Provider Identifier
1083716690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23867 Issued in NC
Practice address
800 Tilghman Dr
Dunn, NC 28334-5510
Phone
(910) 892-7161
NPI assigned
Sep 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23867 NC Primary

Addresses

Primary practice location

800 Tilghman Dr
Dunn, NC 28334-5510

Mailing address

PO Box 409540
Atlanta, GA 30384-9540

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNC

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001456 NC Practitioner - Emergency MedicinePractitioner - Family Practice 8224027651 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Oct 8, 2013 Accepting new patients
North Carolina Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2004 Accepting new patients
Wilson Emergency Physician Partners PLLC Emergency Medicine CurrentSince Aug 26, 2022 Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine PastSince Apr 19, 2020 Accepting new patients
Carolina Coast Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Carolina Coast Emergency Physicains, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

607 Beaman St
Clinton, NC 28328
Phone (910) 590-8729

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083716690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409540",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303849540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345510",
            "telephone_number": "910-892-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JAMES",
        "middle_name": "E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "23867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

Verify at the official NPI Registry.