Nichole Jeanette Pridemore, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

000000 Issued in GA

Practice address

1 Letterman Dr Ste C3500
San Francisco, CA 94129-1494

Phone

(415) 612-1900

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Nichole Jeanette Pridemore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Presidio Health Services, LLC

  dba Presidio Health Services

  • Sleep Medicine (Internal Medicine) Physician
  • San Francisco, CA
  • NPI 1952763856
  NPD (past)
• Presidio Therapy Services, LLC

  dba Presidio Therapy Services

  • Durable Medical Equipment & Medical Supplies
  • San Francisco, CA
  • NPI 1568824233
  NPD (past)
• Saint Mary's Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  NPD (past)
• Trinity Health - Michigan

  dba Heartside Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1902002272
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1376765214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WOODRUFF XING # X-ING",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896148",
            "telephone_number": "419-290-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LETTERMAN DR STE C3500",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291494",
            "telephone_number": "415-612-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Lytton Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943011556",
            "country_code": "US",
            "telephone_number": "650-380-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "NICHOLE",
        "middle_name": "JEANETTE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "303269",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704271769",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "PRIDEMORE",
            "middle_name": "JEANETTE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tobias T Price
• Vera H. Price, M.D.
• Vincent Price
• J. Michael Priddy, PHD
• Michel'la C Pride
• Susan Kay Priefert, L.AC.
• David R. Priest, MD
• Melinda Prieto
• Victor Anthony Prieto, MD
• Jeremy David Prillwitz

• Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.