Individual provider Active NPI

Nicole H Tomlin, FNP

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1114933264
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F2972 Issued in SC
Practice address
2030 N Church Street PL
Spartanburg, SC 29303-2706
Phone
(864) 582-6858
Fax
(864) 582-3750
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F2972 SC Primary

Addresses

Primary practice location

2030 N Church Street PL
Spartanburg, SC 29303-2706

Mailing address

1017 Oak Grove Rd
Landrum, SC 29356-3911
Phone (864) 542-5170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20090420000608 SC Practitioner - Nurse Practitioner 3476600925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F2972SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ikenna F. Onyebueke, MD PA Current Accepting new patients
Lung and Chest Medical Associates, LLC Family CurrentSince Jun 10, 2011 Accepting new patients
Raul B Cruz MD PA Current Accepting new patients

Locations

2030 N Church Street Pl
Spartanburg, SC 29303
Phone (864) 582-5858

Organizations & group practices 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1114933264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 OAK GROVE RD",
            "city": "LANDRUM",
            "state": "SC",
            "postal_code": "293563911",
            "telephone_number": "864-542-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 N CHURCH STREET PL",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032706",
            "telephone_number": "864-582-6858",
            "fax_number": "864-582-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "NICOLE",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F2972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.