Liem Nguyen Nickelson, A.A.

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2011030647 Issued in MO

Practice address

3635 Vista Ave
Saint Louis, MO 63110-2539

Phone

(314) 577-8000

NPI assigned

Sep 12, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Liem Nguyen Fister Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Slu Hospital Anesthesia Physician Billing LLCGroup PAC ID 3274842331, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health Saint Louis University Hospital Hospital, Saint Louis, MO, CCN 260105

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

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.

• SSM Health Slu Hospital Anesthesia Physician Billing, LLC

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1407232804

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD
• SSM Health Care Group

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306589544
  Medicare reassignment NPD
• SSM Health Care Group

  • Dermatopathology Physician
  • Saint Louis, MO
  • NPI 1932844495
  NPD

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

• SSM-Sluh Inc

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1942685920
  Care Compare affiliation

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1760764138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "813-493-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-577-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "LIEM",
        "middle_name": "NGUYEN",
        "credential": "A.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2011030647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIEM",
            "last_name": "FISTER",
            "middle_name": "NGUYEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrienne Nickel, PLPC
• Pamela Marie Nickels, ED.D.
• Suzanne M Nickels, PTA
• Jenna Nickelson
• Jillian Alicia Nickelson
• Nancy J Nickerson, AHCNS
• Amanda Michelle Nicklas, OD
• Sandra Ann Nickles
• Thomas Louis Nickolas, MD
• Riley Nickols

• Anesthesiologist Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiologist Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.