Connie Nickelson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

38911 Issued in TN

Practice address

4260 Oak Trace Dr
Morristown, TN 37813-1378

Phone

(423) 492-3770

NPI assigned

Jul 1, 2006

Last updated

May 8, 2017By 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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

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.

• App of Tennessee HM, PLLC

  • Hospitalist Physician
  • Shelbyville, TN
  • NPI 1396160768
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  dba Ballad Health Medical Associates

  • Pulmonary Disease Physician
  • Bristol, TN
  • NPI 1780986257

  Internal Medicine

  Medicare reassignment NPD
• Hospital Medicine Services of Tennessee PC

  • Hospitalist Physician
  • Lawrenceburg, IN
  • NPI 1528433802

  Internal Medicine, TN

  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Statcare Hospitalists Group

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1528378726
  NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Jackson Madison County General Hospital

  • General Practice Physician
  • Jackson, TN
  • NPI 1467493916

  Internal Medicine

  NPD (past)
• Premier Surgical Associates, PLLC

  • Prosthetic/Orthotic Supplier
  • Knoxville, TN
  • NPI 1285806919
  NPD (past)
• Dodge Emergency Group LLC

  • Nurse Practitioner
  • Eastman, GA
  • NPI 1164481065
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1841229903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 OAK TRACE DR",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131378",
            "telephone_number": "423-492-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 OAK TRACE DR",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131378",
            "telephone_number": "423-492-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELSON",
        "first_name": "CONNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "38911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan-Huy Nguyen, PHARMD
• Quynh Nguyen, PHARMD
• Olivia Nichols
• Stephanie D Nichols, RN, APN
• Teresa Nichols, RN
• Mary Beth Nicley, R.N.
• Joshua Nida, PHARMD
• Jackie C Noah, PA-C
• Maranda Noble, PHARMD
• Angela Jeanette Noe, RN

• Internal Medicine Physician in Morristown, TN
• Providers in Morristown, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.