Alicia Faulk Nicklas, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP09172 Issued in LA

Practice address

104 Genevieve Dr
Lafayette, LA 70503-4811

Phone

(337) 984-0110

Fax

(337) 981-7210

NPI assigned

Apr 18, 2017

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

Enrolled in LA

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lafayette General Medical Center IncGroup PAC ID 4688581457, 80 clinicians

Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Ochsner St Martin Hospital Hospital, Breaux Bridge, LA, CCN 191302
• Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
• Ochsner University Hospital and Clinics Hospital, Lafayette, LA, CCN 190006
• Acadia General Hospital Hospital, Crowley, LA, CCN 190044

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anicklas1443414@direct.ochsner.org

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.

• Lafayette General Medical Center Inc.

  • Cardiovascular Disease Physician
  • Lafayette, LA
  • NPI 1649408832
  Medicare reassignment Care Compare group NPD
• Lafayette Health Ventures Inc

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1417986092
  Medicare reassignment Care Compare group NPD
• Lafayette General Medical Center Inc.

  • Community/Retail Pharmacy
  • Lafayette, LA
  • NPI 1023638715
  NPD
• Lafayette Health Ventures Inc

  • Anesthesiology Physician
  • Jennings, LA
  • NPI 1063124568
  NPD
• Lafayette Health Ventures, Inc

  • Internal Medicine Physician
  • Lafayette, LA
  • NPI 1467687186
  NPD
• Lafayette General Medical Center Inc

  • Specialist
  • Lafayette, LA
  • NPI 1518577030
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Acadia General Hospital, Inc.

  • General Acute Care Hospital
  • Crowley, LA
  • NPI 1669882940
  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1093927105

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1205040995

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Grand Chenier, LA
  • NPI 1407068299

  Hospital

  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • General Acute Care Hospital
  • Lake Charles, LA
  • NPI 1629076468
  Care Compare affiliation
• Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
  • NPI 1710191473

  Hospital

  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• St Martin Hospital, Inc.

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1437482817
  Care Compare affiliation
• University Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1306281126
  Care Compare affiliation

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1487188256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-984-0110",
            "fax_number": "337-981-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-984-0110",
            "fax_number": "337-981-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLAS",
        "first_name": "ALICIA",
        "middle_name": "FAULK",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP09172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Duc Nguyen
• Vu Thanh Nguyen
• Anef Hasan Syed Niaz, MD
• James R Nichols, DDS
• Lauren Nichols, COTA/L
• Christine Nickles
• Christy Soileau Nicko, LCSW
• Kathleen Nickoles
• Paul H Nicoletti
• Brent Smith Nicolini, LPC, LAC

• Pediatric Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.