Amanda Gray Nicols, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20191 Issued in MS

Practice address

501 Marshall Street
Suite 400
Jackson, MS 39202-1687

Phone

(601) 354-0869

NPI assigned

Sep 14, 2007

Last updated

Nov 19, 2011By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Obstetrics/Gynecology

Education

University of Mississippi School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Womans Clinic of Ms PLLCGroup PAC ID 7214003441, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Womans Clinic of Ms PLLC

  • Obstetrics & Gynecology Physician
  • Jackson, MS
  • NPI 1003843210
  NPD
• Caroline a Reich MD PC

  • Diagnostic Radiology Physician
  • Birmingham, AL
  • NPI 1982882270
  NPD (past)

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1720273535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL STREET",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-354-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL STREET",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021687",
            "telephone_number": "601-354-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLS",
        "first_name": "AMANDA",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "20191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08221030",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R Nichols, D.M.D., M.D.
• Todd Applewhite Nichols, MD
• William Patrick Nichols, M.D.
• Kayla Leigh Nicholson, PA-C
• Alisha Nicks, PHARMD
• Lee M Nicols, MD
• John Todd Nida, MD
• Tanner Cole Nielson, MD
• Laurie Selman Nimon, NP
• Nishablessedhands LLC

• Obstetrics & Gynecology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Obstetrics & Gynecology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.