NPIMap

Individual provider Active NPI

Jacqueline Ann Nicholas, M.D.

  • Neurology Physician
  • Columbus, OH
National Provider Identifier
1740457886
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35121311 Issued in OH
Practice address
3535 Olentangy River Rd Ste S1501
Columbus, OH 43214-3908
Phone
(614) 533-5500
Fax
(614) 533-0103
NPI assigned
May 8, 2008
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MT191160 PA
Neurology Physician 2084N0400X 35121311 OH Primary

Addresses

Primary practice location

3535 Olentangy River Rd Ste S1501
Columbus, OH 43214-3908

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
0086020MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jnicholas32198@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000909 OH Practitioner - Neurology 0345480257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Toledo College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

500 Thomas LN
2E
Columbus, OH 43214-1419
Phone (614) 566-9777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35121311OHMDNeurology Physician
MT191160PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Dec 31, 2014 Accepting new patients
Ohiohealth Corporation CurrentSince Dec 31, 2014 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3535 Olentangy River Rd
Ste S1501
Columbus, OH 43214
Phone (614) 788-6100

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

500 Thomas Ln
Ste 2E
Columbus, OH 43214
Phone (614) 566-9777

Dept L3652
Columbus, OH 43260

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1740457886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 OLENTANGY RIVER RD STE S1501",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143908",
            "telephone_number": "614-533-5500",
            "fax_number": "614-533-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MT191160",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35121311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0086020",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnicholas32198@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3535 Olentangy River Rd",
            "address_2": "Ste S1501",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.