Nichole Douglass, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

RN205945 Issued in GA

Practice address

1955 Lake Park Dr SE Ste 300
Smyrna, GA 30080-8855

Phone

(770) 319-4705

Fax

(770) 514-2803

NPI assigned

Apr 27, 2012

Last updated

Apr 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1336407212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 LAKE PARK DR SE STE 300",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808855",
            "telephone_number": "770-319-4705",
            "fax_number": "770-514-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 LAKE PARK DR SE STE 300",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808855",
            "telephone_number": "770-319-4705",
            "fax_number": "770-514-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "NICHOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "RN205945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Odetta Mary Dodson, LMT
• Jeny Fernanda Dominguez Castillo
• Kimberly Lynn Domon
• Donald F. Marshall D.D.S. P.C.
• Martha Louise Dorsey, PH.D.
• Paul Lawrence Douglass, M.D.
• Samantha Dove, DPT
• Rebecca Downes, RPH
• Dietria L Downs, RD, LD
• Mark Candler Doyal, CCC-SLP

• Case Management Registered Nurse in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Case Management Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.