Active NPI
Kristina Elizabeth Nichols, PA
- Physician Assistant
- Charlotte, NC
National Provider Identifier
1255368155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-00886
- Practice address
- 1000 Blythe Blvd
CMC Annex 1St Floor
Charlotte, NC 28203-5812 - Phone
- (704) 355-0720
- Fax
- (704) 355-5948
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-00886 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
CMC Annex 1St Floor
Charlotte, NC 28203-5812
Mailing address
PO Box 601643
Charlotte, NC 28260-1643
Phone (704) 355-0720
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1071PA | Medicaid | SC | |
| 1255368155 | Medicaid | NC | |
| 8102218 | Medicaid | NC |
Other names 1
- Miss Kristina Elizabeth Hohas
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-00886 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Englewood Medical Associates Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Englewood, NJ
- NPI 1174564421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416182400000",
"number": "1255368155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601643",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601643",
"telephone_number": "704-355-0720",
"fax_number": "704-355-5948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"address_2": "CMC ANNEX 1ST FLOOR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-0720",
"fax_number": "704-355-5948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "KRISTINA",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2014-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-00886",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1071PA",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255368155",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8102218",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTINA",
"last_name": "HOHAS",
"middle_name": "ELIZABETH",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.