Jessica L Nichols, MS, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23002292A Issued in IN

Practice address

304 Detroit St
La Porte, IN 46350-2497

Phone

(219) 325-3770

Fax

(219) 325-8181

NPI assigned

Apr 8, 2008

Last updated

Sep 21, 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

Other identifiers 2

Other names 1

• Jessica L Barr Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Porte Clinic Company LLCGroup PAC ID 0446558357, 66 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.68 of 100Reported as apm

Quality

76.2

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.nichols@laportehosp.cernerdirect.com

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.

• La Porte Clinic Company LLC

  • Internal Medicine Physician
  • Valparaiso, IN
  • NPI 1568829224
  Medicare reassignment Care Compare group NPD
• La Porte Clinic Company LLC

  dba La Porte Physician Network Ophthalmology Care

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1275081788
  NPD

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1972776292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 KELLE DR",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463048708",
            "telephone_number": "219-364-4004",
            "fax_number": "219-326-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 DETROIT ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502497",
            "telephone_number": "219-325-3770",
            "fax_number": "219-325-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JESSICA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002292A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000770974",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200387170",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jessica.Nichols@laportehosp.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "304 Detroit St",
            "city": "LA Porte",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463502497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BARR",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Audiologist in La Porte, IN
• Providers in La Porte, IN by specialty
• Audiologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.