Stephen Edwin Nicolson, M.D.

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

48549 Issued in TN

Practice address

1313 21St Ave S
Vanderbilt University Medical Center, 1103 Oxford House
Nashville, TN 37232-0001

Phone

(615) 875-5838

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

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

Geriatric PsychiatryAlso: Psychiatry

Education

Un of California, Irvine, College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snicolson253936@direct.bilh.masshiway.net

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.

• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131
  Medicare reassignment Care Compare group NPD
• Jordan Physician Associates, Inc.

  dba BIDH-Plymouth Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD

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

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1497734461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 21ST AVE S",
            "address_2": "VANDERBILT UNIVERSITY MEDICAL CENTER, 1103 OXFORD HOUSE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-875-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 21ST AVE S",
            "address_2": "VANDERBILT UNIVERSITY MEDICAL CENTER, 1103 OXFORD HOUSE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-875-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLSON",
        "first_name": "STEPHEN",
        "middle_name": "EDWIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "054333",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "243838",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "TN",
            "license": "48549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02896519",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2117096",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Scott Nickels, DDS PC
• Taylor Nickens
• Bridget Nicol
• Vicky Nicolas
• Lacey Nicolau, FNP-BC
• Jonathan Niconchuk, M.D.
• Nida Steiner, O.D. LLC
• Kathryn M Nides, RD
• Jan Alexander Niec
• Michael E Niedermeyer, MD

• Psychosomatic Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Psychosomatic Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.