Nichole Renae Friessen, PA
Individual provider Active NPI Surgical Physician Assistant · Dakota Dunes, SD
NPI 1790746105 · NPPES record last updated Sep 29, 2010
Key facts
- NPI
- 1790746105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 0631 (SD)
- Practice address
- 575 Sioux Point Road
Dakota Dunes, SD 57049 - Phone
- (605) 217-2667
- Fax
- (605) 217-2900
- NPI assigned
- Mar 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cnos PC
Practice addresses (Care Compare)
212 Plymouth St SW
Le Mars, IA 51031-3441
Phone (605) 217-2667
2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500
2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667
600 N Sioux Point Rd
Dakota Dunes, SD 57049-5000
Phone (605) 232-3332
801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010
Hospital & facility affiliations
- Dunes Surgical Hospital
- St Lukes Regional Medical Center
- Cherokee Regional Medical Center
- Floyd Valley Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in IA, SD, NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070206000736 | IA | Practitioner - Physician Assistant | 2466452016 | Reassigns benefits to 1 organization |
| I20070210000137 | SD | Practitioner - Physician Assistant | 2466452016 | Reassigns benefits to 1 organization |
| I20230316000219 | NE | Practitioner - Physician Assistant | 2466452016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2860 | NE | MD | Mental Health Counselor |
| 001430 | IA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cnos PC | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients |
Locations
212 Plymouth St SW
Le Mars, IA 51031
Phone (712) 546-7789
2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000
2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692
1200 Providence Rd
Wayne, NE 68787
Phone (402) 375-3800
575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615
Interoperability endpoints
- nfriessen128208@direct.unitypoint.org
- nicholefriessen@cnos.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 001430 | IA | |
| Surgical Physician Assistant | 363AS0400X | 0631 | SD | Yes |
Addresses
Primary practice location
575 Sioux Point Road
Dakota Dunes, SD 57049
Mailing address
575 Sioux Point Road
Dakota Dunes, SD 57049
Phone (605) 217-2667
Other providers in Dakota Dunes, SD
- Larry D Foster
- Sara Ann Fouts
- Elizabeth Shepperd Frank
- Christy Lynn Fravel
- Makayla Freemont
- Abbie A Gacke
- Sandra Lizett Garcia
- Willy Ann Garcia
- General Surgery and Diagnostics PC
- Michael Christopher Genoff
All providers in Dakota Dunes, SD · Surgical Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.