Amy Dawn Nichols, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN241696 Issued in GA

Practice address

1236 Franklin Pkwy
Franklin, GA 30217-7508

Phone

(706) 675-8669

NPI assigned

Nov 30, 2020

Last updated

Nov 30, 2020By 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1912501966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 OLD JONES RD",
            "city": "WHITESBURG",
            "state": "GA",
            "postal_code": "301852821",
            "telephone_number": "770-851-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 FRANKLIN PKWY",
            "city": "FRANKLIN",
            "state": "GA",
            "postal_code": "302177508",
            "telephone_number": "706-675-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Wellington Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Whitesburg",
            "state": "GA",
            "postal_code": "301852606",
            "country_code": "US",
            "telephone_number": "770-836-0504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4248 Mount Zion Rd",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301177602",
            "country_code": "US",
            "telephone_number": "770-836-0103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN241696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juanita Jackson, M.S., LPC
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• Oar to Shore Performance LLC
• Pathways Center for Behavioral and Developmental Disabilities
• Pathways Center for Behavioral and Developmental Growth
• Payton Nichole Phillips
• Pruitthealth - Franklin, LLC (PruittHealth - Franklin)

• Family Nurse Practitioner in Franklin, GA
• Providers in Franklin, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.