Julie A Nickelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21062 Issued in CA

Practice address

2767 Olive Hwy
Oroville, CA 95966-6118

Phone

(530) 533-8500

NPI assigned

Jul 29, 2010

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 names 1

• Julie A Ivany Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1750695904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500",
            "fax_number": "530-532-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "IVANY",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hanh Katelyn Nguyen, D.O.
• Jessica Nguyen
• Xuan Thanh Nguyen, PA
• Katia Nicholaw, NP
• Lowell D. Nickel, M.D.
• Arash Nikookar
• Norcal Wound Care, Inc
• North State Radiology Medical Group Inc
• North State Radiology Medical Group Inc
• North State Urology Medical Assoc Inc

• Physician Assistant in Oroville, CA
• Providers in Oroville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.