Individual provider Active NPI

Nicole A Thomas, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1841810447
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-168583 Issued in AL
Practice address
2817 30TH Ave N
Birmingham, AL 35207-4541
Phone
(205) 407-6900
NPI assigned
Apr 23, 2020
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-168583 AL Primary
Registered Nurse 163W00000X 1-168583 AL

Addresses

Primary practice location

2817 30TH Ave N
Birmingham, AL 35207-4541

Mailing address

2817 30TH Ave N
Birmingham, AL 35207-4541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241216000181 AL Practitioner - Nurse Practitioner 8820524747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

712 25TH St N
Birmingham, AL 35203-2400
Phone (205) 323-5311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-168583ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Regional Medical Services CurrentSince Sep 30, 2024 Accepting new patients
Alabama Regional Medical Services Current Accepting new patients
Alabama Regional Medical Services CurrentSince Sep 30, 2024 Accepting new patients

Locations

2817 30th Ave N
Birmingham, AL 35207
Phone (205) 323-4548

712 25th St N
Birmingham, AL 35203
Phone (205) 323-5311

417 19th Street Ensley
Ensley, AL 35218
Phone (205) 547-2344

7001 Crestwood Blvd
Ste 822
Irondale, AL 35210
Phone (205) 421-9615

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1841810447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 30TH AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352074541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 30TH AVE N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352074541",
            "telephone_number": "205-407-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-10-17",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-168583",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-168583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.