Amy L Nicholas, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA03950 Issued in TX

Practice address

1650 W Northwest Hwy Ste 200
Grapevine, TX 76051-8122

Phone

(972) 716-3922

Fax

(214) 948-5516

NPI assigned

Sep 22, 2005

Last updated

Aug 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy L Hicks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Medhealth

  dba Methodist Medical Group

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1811983174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 SOUTHLAKE PARK RD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760922501",
            "telephone_number": "214-668-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W NORTHWEST HWY STE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518122",
            "telephone_number": "972-716-3922",
            "fax_number": "214-948-5516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Five Points Dr Ste 169",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760186057",
            "country_code": "US",
            "telephone_number": "972-556-6946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5407 Basswood Blvd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761374499",
            "country_code": "US",
            "telephone_number": "972-556-6946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HICKS",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kim Nguyen, PHARMD
• Linda Nguyen
• Nicole Nguyen, MD
• Tien Van Nguyen, PHARM D.
• Vilinh Nguyen, PHARM.D.
• Richard Alan Nichols, PA DPM
• Connor Nickerson, LCSW
• NMS DME LLC (One Salon)
• Nortex Laboratories LLC
• North DFW Urology LLP

• Medical Physician Assistant in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.