Individual provider Active NPI

Cincy Lou Nicholson

  • Family Nurse Practitioner
  • Asheville, NC
National Provider Identifier
1972079481
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09180332 Issued in NC
Practice address
136 Charlotte Hwy
Asheville, NC 28803-9624
Phone
(828) 296-0880
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09180332 NC Primary

Addresses

Primary practice location

136 Charlotte Hwy
Asheville, NC 28803-9624

Mailing address

PO Box 148
Etowah, NC 28729-0148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20221109000757 MT Practitioner - Nurse Practitioner 7911243233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health and Wellness IncGroup PAC ID 9436566437, 7 clinicians

Practice addresses (Care Compare)

108 E 9TH St
Suite 1
Libby, MT 59923-2019
Phone (706) 293-3113

Hospital & facility affiliations

  • Cabinet Peaks Medical Center Hospital, Libby, MT, CCN 271320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F09180332NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health & Wellness, Inc. CurrentSince Sep 12, 2022 Accepting new patients

Locations

108 E 9th St
Ste 1
Libby, MT 59923
Phone (406) 293-3113

34169 US Highway 2
Libby, MT 59923
Phone (406) 293-3113

34169 US Highway 2
Ste 1
Libby, MT 59923

Interoperability endpoints

  • Direct secure messaging: cincy.nicholson@330576480108548.direct.elationemr.com

Organizations & group practices 1

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 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": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1972079481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "ETOWAH",
            "state": "NC",
            "postal_code": "287290148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CHARLOTTE HWY",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288039624",
            "telephone_number": "828-296-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CINCY",
        "middle_name": "LOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F09180332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.