Jessica Dawn Nichols, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021017873 Issued in MO

Practice address

301 N Highway 21
Pilot Knob, MO 63663-7862

Phone

(573) 546-1260

NPI assigned

Jun 1, 2021

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 MO

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iron County Hospital District 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iron County Medical Center Hospital, Pilot Knob, MO, CCN 261336
• Madison Medical Center Hospital, Fredericktown, MO, CCN 261302
• Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308

Merit-based Incentive Payment System (MIPS)

Final score

67.5 of 100Reported as group

Quality

53.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jessica.nichols.1@16878.direct.athenahealth.com

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.

• Iron County Hospital District

  • Critical Access Hospital
  • Pilot Knob, MO
  • NPI 1477648178

  MO

  Medicare reassignment Care Compare group NPD
• Iron County Hospital District

  • Rural Health Clinic/Center
  • Pilot Knob, MO
  • NPI 1073799367
  Care Compare group NPD

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

• Iron County Hospital District

  • Critical Access Hospital
  • Pilot Knob, MO
  • NPI 1477648178

  Hospital

  Care Compare affiliation
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Critical Access Hospital
  • Fredericktown, MO
  • NPI 1720163025

  Hospital

  Care Compare affiliation
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1760058739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 FOX GLN",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636408712",
            "telephone_number": "573-366-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N HIGHWAY 21",
            "city": "PILOT KNOB",
            "state": "MO",
            "postal_code": "636637862",
            "telephone_number": "573-546-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JESSICA",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021017873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Sue Leslie, RDH
• Madison Medical Center Stockhoff Memorial Nursing Home
• Meadowbrook Residential Care
• Judith Medley, MSN, RN, FNP, CPNP
• Johnny Franklin Miller, CRADC
• Ozark Valleys Community Services, Inc.
• Ian Pelletier, DO
• Amy Phillips, RDH
• Brittany Queen, RDH
• Tasha Rosenquist

• All providers in Pilot Knob, MO
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.