Stacey Anna Nicholson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0432131 Issued in KS

Practice address

5500 E Kellogg Dr
Wichita, KS 67218-1607

Phone

(316) 259-0560

NPI assigned

May 1, 2007

Last updated

Jan 9, 2014By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Peg Bicker MD, LLC

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1952748774
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1710108774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-259-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-259-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "STACEY",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0432131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Elizabeth Nichols, MD
• Stacy A. Nichols, LPC
• Tina Kay Nichols, LPN, I.V.
• Ashlea Michelle Nicholson, LMAC, LMFT
• Kaley Nicholson, LMSW
• Anthony Nickel, MD
• Darrin Todd Nickel, LCMFT
• Nicole Lynne Nickel, SLP CCC
• Sarah Marie Nickel, RPT
• Terri A Nickel, DO

• Internal Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.