| Dr Tiffani Maria Nichols, DO | |
|
716 Spring St, Suite 204, Wise, VA 24293 | |
| (276) 328-8910 | |
| (276) 328-4318 |
| Full Name | Dr Tiffani Maria Nichols |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 20 Years |
| Location | 716 Spring St, Wise, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760678106 | NPI | - | NPPES |
| P00739464 | Other | RR MEDICARE | |
| 7100077080 | Medicaid | KY | |
| 1760678106 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0102202126 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Whitley County Home Health Agency | Williamsburg, KY | Home health agency |
| Mountain Community Hospice Dba Bluegrass Care Navi | Hazard, KY | Hospice |
| Baptist Health Corbin | Corbin, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pt Pros, Inc | 0143139337 | 218 |
| Baptist Health Medical Group Inc | 5597867184 | 2132 |
| Entity Name | Baptist Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740586213 PECOS PAC ID: 5597867184 Enrollment ID: O20070228000503 |
| Entity Name | Baptist Health Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518360296 PECOS PAC ID: 5597867184 Enrollment ID: O20150206000249 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tiffani Maria Nichols, DO 716 Spring St, Suite 204, Wise, VA 24293 Ph: (276) 328-8910 | Dr Tiffani Maria Nichols, DO 716 Spring St, Suite 204, Wise, VA 24293 Ph: (276) 328-8910 |
Dr. Eleanor Sue Cantrell, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 134 Roberts Ave Sw, Wise, VA 24293 Phone: 276-328-8000 Fax: 276-376-1020 | |
Dr. Latisha Mechele Hilton, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 716 Spring Street, Suite 204, Wise, VA 24293 Phone: 276-329-8910 Fax: 276-328-4318 | |
Chritsopher T. Starnes, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 143 Woodland Dr Sw, Wise, VA 24293 Phone: 276-365-8071 Fax: 276-221-1529 |