Nichole Johnson Prestwood, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-141456 Issued in AL

Practice address

106 Westside Dr
Dothan, AL 36303-1908

Phone

(877) 231-3376

Fax

(850) 522-8354

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Dermatology Group PAGroup PAC ID 9931277233, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GAGFCD

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.

• Southeastern Dermatology Group PA

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231

  AL

  Medicare reassignment Care Compare group NPD
• Aqua Dermatology of Alabama PC

  • MOHS-Micrographic Surgery Physician
  • Vestavia HLS, AL
  • NPI 1477708642
  Medicare reassignment NPD
• Rao Heart & Vascular LLC

  • Cardiovascular Disease Physician
  • Dothan, AL
  • NPI 1831864891
  NPD
• Cutaneous Oncology & Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Vestavia HLS, AL
  • NPI 1699139915
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1225522709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "877-231-3376",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "989 Elba Hwy",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "AL",
            "postal_code": "360796050",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Jackson St Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "AL",
            "postal_code": "363303175",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTWOOD",
        "first_name": "NICHOLE",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-141456",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-141456",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP BOARD CERTIFICATION",
            "identifier": "F06180238",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1-141456",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parks Winfield Pratt III, MD
• Precision Wound Care LLC
• Premier Cardiology Associates PLLC
• Premier Cardiology Consultants Inc
• Brooke Preston
• James Timothy Price, LPC
• Kimberly Dionne Price, LMSW
• Tyler Wayne Prim, DMD
• Primary Care Consultants, PC
• Primecare Occupational Medicine, LLC

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.