Jane Elizabeth Nicholas, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20979 Issued in WV

Practice address

800 Pennsylvania Ave
Charleston, WV 25302-3351

Phone

(304) 414-1880

Fax

(304) 414-1886

NPI assigned

Jul 16, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jane.nicholas.1@7363.direct.athenahealth.com

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.

• Women Care Inc

  • Federally Qualified Health Center (FQHC)
  • Scott Depot, WV
  • NPI 1194759290

  Pediatrics

  Medicare reassignment NPD
• Womencare Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1316228166
  NPD
• Womencare, Inc

  • Federally Qualified Health Center (FQHC)
  • Winfield, WV
  • NPI 1760268643
  NPD

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1104056878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD",
            "address_2": "STE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609816",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253023351",
            "telephone_number": "304-414-1880",
            "fax_number": "304-414-1886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3729 Teays Valley Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269705",
            "country_code": "US",
            "telephone_number": "304-760-6040",
            "fax_number": "304-697-2086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "20979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003934000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Nice
• Charlize B Nicely
• Melissa Niceschwander
• Brooke Nicewarner
• Ellen Nicholas
• Dennis Nichols
• Jaiden Nichols
• James M Nichols, PARAPROFESSIONAL
• Katelyn Nichols
• Morgan Nichols

• Pediatrics Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.