Nicole Hines
Individual provider Active NPI Speech-Language Pathologist · Albuquerque, NM
NPI 1831214261 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831214261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 3927 (NM)
- Practice address
- 5200 Copper Ave NE
Albuquerque, NM 87108-1473 - Phone
- (505) 255-5099
- Fax
- (505) 255-4206
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Board of Regents of the University System of Georgia
Practice addresses (Care Compare)
110 Carlton St
Athens, GA 30602-1526
Phone (706) 542-4598
Merit-based Incentive Payment System (MIPS)
- Final score
- 57.28 of 100
- Quality
- 60.36
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 80.58
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220401000821 | GA | Practitioner - Qualified Speech Language Pathologist | 3375939291 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3927 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Regents of the University System of Georgia | Current |
Accepting new patients | |
| Board of Regents of the University System of Georgia | Speech-Language Pathologist | Current | Accepting new patients |
| Board of Regents of the University System of Georgia | Current |
Accepting new patients | |
| ENT of Georgia, LLC | Past | Accepting new patients | |
| Sisu of Georgia, Inc | Speech-Language Pathologist | Past | Accepting new patients |
Locations
110 Carlton St
Athens, GA 30602
Phone (706) 542-4598
55 Carlton St
Athens, GA 30602
Phone (706) 542-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3927 | NM | Yes |
Addresses
Primary practice location
5200 Copper Ave NE
Albuquerque, NM 87108-1473
Mailing address
5200 Copper Ave NE
Albuquerque, NM 87108-1473
Phone (505) 255-5099
Other providers in Albuquerque, NM
- Rebekah Hindi
- Alexis Sydney Hinds
- Juliana J Hine
- Catherine Hines
- Kelly Hines
- Stephanie Hines
- Tatyona Hines
- Robin Hinman
- Eugene I Hinojos Jr.
- Rose Marie Hinojosa
All providers in Albuquerque, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- 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.