Active NPI
Debra Lee Nicholls, ARNP
- Acute Care Nurse Practitioner
- Prescott Valley, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 265112
- Practice address
- 7700 E Florentine Rd Ste 206
Prescott Valley, AZ 86314-2245 - Phone
- (928) 442-8117
- Fax
- (928) 772-8947
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | AP61337993 | WA | |
| Acute Care Nurse Practitioner | 363LA2100X | 265112 | AZ | Primary |
Addresses
Primary practice location
7700 E Florentine Rd Ste 206
Prescott Valley, AZ 86314-2245
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206471 | Medicaid | AZ |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | credentialing@postacute.org | Direct | |
| Direct Messaging Address | credentialing@postacute.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7700 E Florentine Rd
Suite 206
Prescott Valley, AZ 86314-2245
Phone (928) 442-8117
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP61337993 | WA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yavapai Regional Medical Center Physician Care LLC | Current | Accepting new patients | |
| Cardiorenal Therapeutics of Washington, PLLC | Current | Accepting new patients | |
| Yavapai Regional Medical Center Physician Care LLC | Current | Accepting new patients | |
| Yavapai Regional Medical Center Physician Care LLC | Current | Accepting new patients | |
| Post Acute Medical PLLC | Current | Accepting new patients | |
| Prescott Gastroenterology | Past | Accepting new patients |
Locations
400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297
3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818
7700 E Florentine Rd
Ste 206
Prescott Valley, AZ 86314
Phone (928) 442-8117
33530 1st Way S
Ste 44
Federal Way, WA 98003
Phone (253) 300-8447
6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273
Organizations & group practices 6
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.
-
- Cardiovascular Disease Physician
- Prescott, AZ
- NPI 1255582003
-
- Internal Medicine Physician
- Tacoma, WA
- NPI 1467054924
-
- Geriatric Medicine (Internal Medicine) Physician
- Lanham, MD
- NPI 1730713025
WA
-
- Internal Medicine Physician
- Prescott, AZ
- NPI 1083940399
-
- Cardiovascular Disease Physician
- Prescott, AZ
- NPI 1528394830
-
- Gastroenterology Physician
- Prescott, AZ
- NPI 1720110984
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
-
- General Acute Care Hospital
- Prescott, AZ
- NPI 1902897820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1730770579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10880",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863040880",
"telephone_number": "602-406-4786",
"fax_number": "916-636-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7700 E FLORENTINE RD STE 206",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863142245",
"telephone_number": "928-442-8117",
"fax_number": "928-772-8947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLLS",
"first_name": "DEBRA",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "WA",
"license": "AP61337993",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "265112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206471",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "credentialing@postacute.org",
"affiliation": "N",
"endpointDescription": "work affiliation",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "direct",
"address_1": "1554 Pennsylvania Ave",
"city": "Bremerton",
"state": "WA",
"country_code": "US",
"postal_code": "983371145",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "credentialing@postacute.org",
"affiliation": "N",
"endpointDescription": "work affiliation",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "direct",
"address_1": "1554 Pennsylvania Ave",
"city": "Bremerton",
"state": "WA",
"country_code": "US",
"postal_code": "983371145",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Prescott Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.