Theodore Nicholson, MD in Carrollton, GA - Medicare Emergency Medicine

Theodore Nicholson, MD is a medicare enrolled "Emergency Medicine" physician in Carrollton, Georgia. His current practice location is 705 Dixie St, Carrollton, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 836-9666.

Theodore Nicholson is licensed to practice in Georgia (license number 029920) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275590051.

Contact Information

	Theodore Nicholson, MD
	705 Dixie St, Carrollton, GA 30117-3818
	(770) 836-9666
	Not Available

Map and Direction

Physician's Profile

Full Name	Theodore Nicholson
Gender	Male
Speciality	Emergency Medicine
Location	705 Dixie St, Carrollton, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275590051
Provider Enumeration Date: 04/27/2006
Last Update Date: 04/28/2010

Medicare PECOS Information:

PECOS PAC ID: 9335040245
Enrollment ID: I20040115000003

Medical Identifiers

Medical identifiers for Theodore Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275590051	NPI	-	NPPES
000390288B	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207PE0004X	Emergency Medicine - Emergency Medical Services	029920 (Georgia)	Secondary
207P00000X	Emergency Medicine	029920 (Georgia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Theodore Nicholson allows following entities to bill medicare on his behalf.

Entity Name	Carrollton Emergency Physicians Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790724672 PECOS PAC ID: 7416860010 Enrollment ID: O20040122001028

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodore Nicholson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Theodore Nicholson, MD 2346 Bowwood Ct, Villa Rica, GA 30180-9733 Ph: () -	Theodore Nicholson, MD 705 Dixie St, Carrollton, GA 30117-3818 Ph: (770) 836-9666

Reviews and Comments

Emergency Medicine Doctors in Carrollton, GA

Brett Wynn, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666
Jesse Mitchell Jr., M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666
Nathan Hundley, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-812-9597
Michael Eckert, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Tanner Health Systems, Emergency Dept, Carrollton, GA 30117 Phone: 770-836-9666
Richard Whitaker, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666
Timothy Paul, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-836-9666

Theodore Nicholson, MD - Medicare Emergency Medicine in Carrollton, GA