Individual provider Active NPI

Vincent Michael Nicolais, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Columbus, GA
National Provider Identifier
1205978434
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
34676 Issued in GA
Practice address
710 Center St
Columbus, GA 31901-1527
Phone
(706) 571-1454
NPI assigned
Feb 13, 2007
Last updated
Oct 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 17941 CT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 34676 GA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 131631 NY

Addresses

Primary practice location

710 Center St
Columbus, GA 31901-1527

Mailing address

5110 Midland Trce
Midland, GA 31820-3426
Phone (706) 561-4992

Other identifiers 1

IdentifierTypeStateIssuer
00462789CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17941CTMDCritical Care Medicine (Internal Medicine) Physician
34676GAMDCritical Care Medicine (Internal Medicine) Physician
131631NYMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince May 1, 2020 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince May 1, 2020 Accepting new patients
Internal Medicine Education and Research Foundation Critical Care Medicine Past Accepting new patients
Internal Medicine Education & Research Foundation of Columbus, Inc Past Accepting new patients

Locations

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

710 Center St
#81
Columbus, GA 31901
Phone (706) 571-1527

710 Center St
Ste A
Columbus, GA 31901
Phone (706) 571-1454

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1205978434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 MIDLAND TRCE",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318203426",
            "telephone_number": "706-561-4992",
            "fax_number": "706-561-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CENTER ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011527",
            "telephone_number": "706-571-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAIS",
        "first_name": "VINCENT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "17941",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "34676",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "131631",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00462789C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.