Amanda Nichols, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1592 Issued in SC

Practice address

295 Midland Pkwy
Summerville, SC 29485-8104

Phone

(843) 832-5160

NPI assigned

Feb 3, 2011

Last updated

Jul 1, 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 SC

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

Physician Assistant

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1750687091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MIDLAND PKWY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858104",
            "telephone_number": "843-832-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MIDLAND PKWY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858104",
            "telephone_number": "843-832-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Hope Professional Psychological Services, LLC
• Lenzee Newman, LMSW
• Meghan V Newman, LMHC
• Tamara Lorease Newton, MS,LPCA
• Bich Ngoc Nguyen
• Suzanne Michele Nicklas, IBCLC
• Daria Lauren Nicolaro
• Gregory W Niemer, M.D.
• Rachel Marie Nienaber, PA
• Nix Justine Gracie Corp, (DBA Comfort Keepers 988)

• Medical Physician Assistant in Summerville, SC
• Providers in Summerville, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.