Maranda Elizabeth Nichols, PA-C, MPH

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

4334 E Highland Dr
Ste a
Jonesboro, AR 72401-6621

Phone

(870) 802-0012

Fax

(870) 972-5140

NPI assigned

Jan 8, 2013

Sex

Female

Sole proprietor

No

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

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Doctors Health Group

  • Occupational Medicine Physician
  • Jonesboro, AR
  • NPI 1841253622
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1346587599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 E HIGHLAND DR",
            "address_2": "STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016621",
            "telephone_number": "870-802-0012",
            "fax_number": "870-972-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 E HIGHLAND DR",
            "address_2": "STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016621",
            "telephone_number": "870-802-0012",
            "fax_number": "870-972-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARANDA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raphael N Ngengwe, MD
• Henry M Nguyen
• Linda Nguyen, P.A.
• Amanda Elizabeth Nichols, BS PHARMACY
• David R Nichols, MD
• Meagan Nichols
• Melissa Suzanne Nichols
• Sara Jane Nichols, BSE/MSE
• Virginia Nicholson
• Bryan Nicolle

• Medical Physician Assistant in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Medical Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.