JACQUELINE ECKERT NICHOLS PA-C NPI 1689971079

NPI Information

NPI: 1689971079
Provider Name: JACQUELINE ECKERT NICHOLS, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
5673 PEACHTREE DUNWOODY RD STE 870
ATLANTA, GA
ZIP 30342
Phone: (404) 255-2975
Get Directions

Jacqueline Eckert Nichols, PA-C is a surgical physician assistant in Atlanta, GA. Jacqueline Eckert Nichols, PA-C NPI is 1689971079. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5673 PEACHTREE DUNWOODY RD STE 870
ATLANTA, GA
ZIP 30342-029
Phone: (404) 255-2975
Fax: (404) 255-2276

The NPI 1689971079 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/21/2011 and was last updated on 12/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant			SOUTH CAROLINA	No
2	363AM0700X	Physician Assistant	Medical		SOUTH CAROLINA	No
3	363AS0400X	Physician Assistant	Surgical	8003	GEORGIA	Yes
4	363AS0400X	Physician Assistant	Surgical		SOUTH CAROLINA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	57-0634057	OTHER	SOUTH CAROLINA	PRACTICE TIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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