Nicole S Fennell, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-120271 Issued in AL

Practice address

1108 Ross Clark Cir
Dothan, AL 36301-3022

Phone

(334) 712-3635

Fax

(334) 699-4387

NPI assigned

Aug 20, 2014

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 AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Gut PC

  dba Digestive Health Specialist of the Southeast

  • Gastroenterology Physician
  • Dothan, AL
  • NPI 1073566006
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment NPD
• Premier Cardiology Consultants Inc

  • Cardiovascular Disease Physician
  • Dothan, AL
  • NPI 1033596515
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment
• Gut PC

  • Anesthesiology Physician
  • Dothan, AL
  • NPI 1790201903
  NPD
• Houston County Healthcare Authority

  dba SAMC- Profee Billing

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134
  NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Nurse Practitioner

  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Enterprise, AL
  • NPI 1952845711
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1619376274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-712-3635",
            "fax_number": "334-699-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-712-3635",
            "fax_number": "334-699-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "NICOLE",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-120271",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9382028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Feiner, LPC
• Mayte Fekete, FNP
• Christopher J Felch, ALC
• Kateryna Feldman, MD
• Steven M. Fendley, M.D.
• Ferguson Aesthetic Care and Enhancement Clinic (The FACE Clinic)
• Christen Marie Ferguson, PHARM.D
• John Christian Ferguson, M.D.
• Stephen L Fernandez, MD
• Madeline Fay Ferrell, M.D., PH.D.

• Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.