Nicole Eileen Micklus, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16729 Issued in GA

Practice address

1120 15TH St # Bi5070
Augusta, GA 30912-0004

Phone

(706) 721-2423

NPI assigned

Apr 22, 2024

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• August University - Medical College of Georgia

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1730865619
  NPD

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1780439893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # BI5070",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309126602",
            "telephone_number": "706-721-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # BI5070",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLUS",
        "first_name": "NICOLE",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "16729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J. Cohen, M.D., P.C.
• Michael Ridlehoover DMD LLC
• Madeline Michael
• Marie Michel
• Anthony Scott Micklon, PA-C
• Tracy Williams Middlebrooks Jr., MD
• Kellie Marie Middleton, LMSW
• Kristen Middleton, RD, CSP, LD
• Midlands Prosthetics & Orthotics
• Midtown Surgical Specialists, PC

• Internal Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.