Kimberly Marie Nicholson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

68082 Issued in GA

Practice address

100 Stoneforest Dr
Suite 320
Woodstock, GA 30189-4880

Phone

(770) 516-5199

Fax

(770) 516-5199

NPI assigned

Jul 1, 2008

Last updated

May 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Emory University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta North Dermatology and Skin Care, Inc.Group PAC ID 0648346726, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

68.02 of 100Reported as individual

Quality

36.03

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanta North Dermatology & Skin Care, Inc.

  • Dermatology Physician
  • Woodstock, GA
  • NPI 1215191085
  Medicare reassignment Care Compare group NPD
• Associated Pathologists LLC

  dba Anatomic Pathology Lab

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1124075635
  NPD (past)
• Associated Pathologists, LLC

  dba Associated Pathologists LLC dba PathGroup

  • Anatomic Pathology & Clinical Pathology Physician
  • Nashville, TN
  • NPI 1003863580

  Dermatopathology

  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1427210475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR",
            "address_2": "SUITE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894880",
            "telephone_number": "770-516-5199",
            "fax_number": "770-516-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR",
            "address_2": "SUITE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894880",
            "telephone_number": "770-516-5199",
            "fax_number": "770-516-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "68082",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "GA",
            "license": "68082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Trung Nguyen Jr.
• Kim Nguyen
• Faiz Ehsan Niaz, MD
• Asher F Niazi, MD
• Julie Tierney Nicholson, M.D.
• Daniel Mark Niederjohn, PH.D.
• Katerina Nikolova
• Melanie Jayne Nimmo, LPCC
• Kelly Brumbelow Nix, FNP, BC
• Sharon R. Nix, LPC

• Dermatology Physician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.