Nicholls Family Health Care, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

016807 Issued in GA

Legal business name

NICHOLLS FAMILY HEALTH CARE, P.C.

Practice address

1205 Van Streat Hwy
Nicholls, GA 31554-5025

Phone

(912) 345-2474

Fax

(912) 345-2518

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Winton Cope McNair III

Title

President/Ceo

Phone

(678) 778-8924

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1306021795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 VAN STREAT HWY",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315545025",
            "telephone_number": "912-345-2474",
            "fax_number": "912-345-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 VAN STREAT HWY",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315545025",
            "telephone_number": "912-345-2474",
            "fax_number": "912-345-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLLS FAMILY HEALTH CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "WINTON",
        "authorized_official_middle_name": "COPE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "678-778-8924",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "016807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00274799A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latasha Nicole Gilliard, FNP-BC
• Healthstat on-Site Clinic/Milliken Alma
• Pamela C. Lee, APRN, BC
• Brad M Mobley, PHARMOCIST
• Nicholls Clinic
• Nicholls Pharmacy
• Nicholls Pharmacy LLC
• Tanisha Shuante Riles
• Hope Elizabeth Schermerhorn, CNA
• Myra Sellers, CCC-SLP

• Primary Care Clinic/Center in Nicholls, GA
• Providers in Nicholls, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.