Individual provider Active NPI

Nicole Atkinson, PA

  • Medical Physician Assistant
  • Austin, TX
National Provider Identifier
1184078636
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10452 Issued in TX
Practice address
2217 Park Bend Dr Ste 300
Austin, TX 78758-5674
Phone
(512) 382-1933
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10452 TX Primary

Addresses

Primary practice location

2217 Park Bend Dr Ste 300
Austin, TX 78758-5674

Mailing address

PO Box 73627
Houston, TX 77273-3627
Phone (832) 249-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10452TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Clinic Medical Group, PLLC CurrentSince Apr 24, 2022 Accepting new patients
Neha Reshamwala MD PA CurrentSince Apr 24, 2022 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Woodlands-North Houston Heart Associates, PA Past Accepting new patients

Locations

2217 Park Bend Dr
Ste 300
Austin, TX 78758
Phone (512) 382-1933

Organizations & group practices 4

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1184078636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73627",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772733627",
            "telephone_number": "832-249-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PARK BEND DR STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585674",
            "telephone_number": "512-382-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA10452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.