Individual provider Active NPI

Nicolette Lauren Bigham, PA-C

  • Physician Assistant
  • Belleville, IL
National Provider Identifier
1801222930
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004820 Issued in IL
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 233-7750
NPI assigned
Sep 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004820 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

1107 Mississippi Ave
Apartment 504
Saint Louis, MO 63104-2458
Phone (618) 698-1546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140103001261 IL Practitioner - Physician Assistant 2961630561 Reassigns benefits to 2 organizations
I20150409002313 MO Practitioner - Physician Assistant 2961630561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085004820ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Nov 11, 2013 Accepting new patients
Cepamerica Illinois LLP CurrentSince Nov 11, 2013 Accepting new patients
Vituity - Illinois Auc LLP CurrentSince Jun 1, 2018 Accepting new patients
American Current Care of Kansas PA Current Accepting new patients
American Current Care of Kansas PA Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

801 W Temple Ave
Effingham, IL 62401
Phone (217) 342-5800

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

6401 E Front St
Kansas City, MO 64120
Phone (816) 241-0603

83 Progress Pkwy
Maryland Hts, MO 63043
Phone (314) 434-8174

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1801222930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MISSISSIPPI AVE",
            "address_2": "APARTMENT 504",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042458",
            "telephone_number": "618-698-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-233-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGHAM",
        "first_name": "NICOLETTE",
        "middle_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.