Jimmie Jo Nichols

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

99 Double Knobs Trail
Young Harris, GA 30582

Phone

(706) 835-5370

NPI assigned

Sep 24, 2019

Last updated

Sep 24, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Early Bird Interventions

  • Early Intervention Provider Agency
  • Young Harris, GA
  • NPI 1669275020
  NPD Authorized official

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1790336444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1022",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "305821022",
            "telephone_number": "706-835-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 DOUBLE KNOBS TRAIL",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "30582",
            "telephone_number": "706-835-5370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Double Knobs Trail",
            "address_purpose": "LOCATION",
            "city": "Young Harris",
            "state": "GA",
            "postal_code": "30582",
            "country_code": "US",
            "telephone_number": "706-835-5370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JIMMIE",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Marie Mayhew, MA
• Kayla Leigh Moody, PTA
• Abby Morgan
• Ketron V. Moss, D.M.D.
• Major Moss
• Npcwoods Telemedicine, PLLC
• Pro Medical Transport LLC (Pro Medical Transport)
• Patrick Rushing, DC
• Marissa Shelton Peck, D.C.
• Stefanie Von Ohlen LLC

• Early Intervention Provider Agency in Young Harris, GA
• Providers in Young Harris, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.