Individual provider Active NPI

Andrea Nicholson

  • Nurse Practitioner
  • Mason City, IA
National Provider Identifier
1205280005
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
H112476 Issued in IA
Practice address
250 S Crescent Dr
Suite 200
Mason City, IA 50401-2926
Phone
(641) 494-5300
Fax
(641) 494-5329
NPI assigned
Apr 18, 2016
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X H112476 IA Primary

Addresses

Primary practice location

250 S Crescent Dr
Suite 200
Mason City, IA 50401-2926

Mailing address

250 S Crescent Dr
Mason City, IA 50401-2926
Phone (414) 945-2006

Other practice location 1

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heartcenternurse@1245.direct.myezyaccess.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160504000759 IA Practitioner - Nurse Practitioner 0840599361 Reassigns benefits to 2 organizations
I20180425001520 MN Practitioner - Nurse Practitioner 0840599361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

250 S Crescent Dr
Mason City, IA 50401-2926

616 N 8TH St
Mitchell County Regional Medical Center
Osage, IA 50461-1456
Phone (641) 732-6000

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mason City Clinic PC Nurse Practitioner CurrentSince Apr 25, 2016 Accepting new patients
Mayo Clinic CurrentSince Jan 18, 2023 Accepting new patients
Mayo Clinic CurrentSince Jan 18, 2023 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
Mayo Clinic Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients

Locations

250 S Crescent Dr
Mason City, IA 50401
Phone (541) 422-6588

250 S Crescent Dr
Ste 200
Mason City, IA 50401
Phone (641) 494-5300

621 S Illinois Ave
Ste 103
Mason City, IA 50401

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1205280005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "414-945-2006",
            "fax_number": "641-494-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "address_2": "SUITE 200",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-494-5300",
            "fax_number": "641-494-5329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 W Fountain St",
            "address_purpose": "LOCATION",
            "city": "Albert Lea",
            "state": "MN",
            "postal_code": "560072437",
            "country_code": "US",
            "telephone_number": "507-373-2384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-18",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H112476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heartcenternurse@1245.direct.myezyaccess.com",
            "affiliation": "N",
            "endpointDescription": "Mason City Clinic Direct Email Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "250 S Crescent Dr",
            "address_2": "Suite 200",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504012926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.