Individual provider Active NPI

Jennifer Lynn Nickolite, D.O.

  • Internal Medicine Physician
  • Lincoln, NE
National Provider Identifier
1851534531
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
924 Issued in NE
Practice address
2300 S 16TH St
Lincoln, NE 68502-3704
Phone
(402) 481-8566
NPI assigned
Apr 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 924 NE Primary

Addresses

Primary practice location

2300 S 16TH St
Lincoln, NE 68502-3704

Mailing address

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 481-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000118 NE Practitioner - HospitalistPractitioner - Internal Medicine 5395991756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Kansas City University of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Physician Associates, LLCGroup PAC ID 2365334364, 76 clinicians

Practice addresses (Care Compare)

1600 N 48TH St
Lincoln, NE 68506-1283
Phone (402) 481-8566

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 475-1011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physician Associates, LLC Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Bryan Medical Center Past Accepting new patients

Locations

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851534531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-8566",
            "fax_number": "402-481-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOLITE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.