Michelle D Nicholas, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA550 Issued in AL

Practice address

100 Memorial Hospital Dr
Suite 3a
Mobile, AL 36608-1183

Phone

(251) 342-2641

Fax

(251) 343-9507

NPI assigned

Sep 24, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1942496922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE 3A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081183",
            "telephone_number": "251-342-2641",
            "fax_number": "251-343-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE 3A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081183",
            "telephone_number": "251-342-2641",
            "fax_number": "251-343-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009914168",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051545351",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Rae Nibert, DO
• Nicholas J Pappas, LCSW, LLC
• Alyssa Bray Nicholas, DNP, APRN, FNP-C
• Gabrielle N Nicholas
• Meeta Nicholas, CRNP
• Amy C Nichols, AU.D., PH.D.
• Brandon Woodfin Nichols, M.D.
• Haley Alise Nichols
• Dante Nicholson
• Justin Nicholson, PHARM.D.

• All providers in Mobile, AL
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.