Alicia Konneker Nielsen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-01222 Issued in NC

Practice address

7940 Williams Pond LN
Suite 150
Charlotte, NC 28277-8766

Phone

(704) 752-7779

Fax

(704) 752-7775

NPI assigned

Feb 20, 2008

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1568630887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7940 WILLIAMS POND LN",
            "address_2": "SUITE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778766",
            "telephone_number": "704-752-7779",
            "fax_number": "704-752-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 WILLIAMS POND LN",
            "address_2": "SUITE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778766",
            "telephone_number": "704-752-7779",
            "fax_number": "704-752-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "ALICIA",
        "middle_name": "KONNEKER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Anne Nickerson, NNP-BC
• Kristi Lynn Nicol, PA-C
• Nicole Rist Collins, OD, PLLC
• Michael Francis Nido, PA-C
• Albert O Niedan, DDS
• Hayden Michael Nielsen
• Lucas Christopher Nielsen, MD
• Gary S Niess, MD
• Eric Patrice Sede Nietcho
• Rafael Nieto, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.