Individual provider Active NPI

Kristy Leigh Nichols, CRNP

  • Nurse Practitioner
  • Andalusia, AL
National Provider Identifier
1891945614
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-073811 Issued in AL
Practice address
301 Medical Ave Ste C
Andalusia, AL 36420-1105
Phone
(334) 222-2073
NPI assigned
Sep 29, 2008
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-073811 AL Primary

Addresses

Primary practice location

301 Medical Ave Ste C
Andalusia, AL 36420-1105

Mailing address

PO Box 1720
Andalusia, AL 36420-1229
Phone (334) 222-2073

Other practice location 1

847 W Bypass Ste A
Andalusia, AL 36420-4747
Phone (334) 428-2273

Other practice location 2

848 S Three Notch St
Andalusia, AL 36420-5320
Phone (334) 427-3034

Other identifiers 2

IdentifierTypeStateIssuer
510-09630OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
237989MedicaidAL

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
I20081216000060 AL Practitioner - Nurse Practitioner 9830251412 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 Medical Park Dr
Suite B
Andalusia, AL 36420-5352
Phone (334) 222-1366

301 Medical Ave
Suite C
Andalusia, AL 36420-1105
Phone (334) 222-1211

7449 Eastchase Pkwy
Montgomery, AL 36117-6846
Phone (334) 747-4030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
78.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-073811ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Nov 1, 2024 Accepting new patients
Andalusia Physician Practices LLC CurrentSince Oct 1, 2018 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Nov 1, 2024 Accepting new patients
Andalusia Physician Practices LLC Current Accepting new patients
Emergency Services of Montgomery PC Nurse Practitioner CurrentSince Nov 1, 2021 Accepting new patients
Rural Urgent Care LLC CurrentSince Aug 1, 2017 Accepting new patients
Rural Urgent Care LLC CurrentSince Aug 1, 2017 Accepting new patients
Andalusia Physician Practices LLC Nurse Practitioner CurrentSince Oct 1, 2018 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
Andalusia Professional Services LLC Nurse Practitioner PastSince Oct 5, 2021 Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients

Locations

301 Medical Ave
Ste A
Andalusia, AL 36420
Phone (334) 222-9100

301 Medical Ave
Ste C
Andalusia, AL 36420
Phone (334) 222-1211

847 W Bypass
Ste A
Andalusia, AL 36420
Phone (334) 222-1366

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

7449 Eastchase Pkwy
Montgomery, AL 36117
Phone (334) 747-4030

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

Interoperability endpoints

  • Direct secure messaging: kristy_hooks_-_np@yourcarecommunity.org
  • Direct secure messaging: kristy.hooks.1@19364.direct.athenahealth.com

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1891945614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1720",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201229",
            "telephone_number": "334-222-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEDICAL AVE STE C",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201105",
            "telephone_number": "334-222-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "847 W Bypass Ste A",
            "address_purpose": "LOCATION",
            "city": "Andalusia",
            "state": "AL",
            "postal_code": "364204747",
            "country_code": "US",
            "telephone_number": "334-428-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "848 S Three Notch St",
            "address_purpose": "LOCATION",
            "city": "Andalusia",
            "state": "AL",
            "postal_code": "364205320",
            "country_code": "US",
            "telephone_number": "334-427-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KRISTY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-073811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "510-09630",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237989",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

Verify at the official NPI Registry.