Bobby Ray Nichols Iii, FNP-C in Mountain City, TN

Bobby Ray Nichols Iii, FNP-C is a medicare enrolled "Nurse Practitioner" in Mountain City, Tennessee. He went to Lincoln Memorial University Medical Department and graduated in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Blue Ridge Medical Management Corporation and his current practice location is 1901 S Shady St, Mountain City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 727-1150.

Bobby Ray Nichols Iii is licensed to practice in Tennessee (license number 26999) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1205468923.

Contact Information

	Bobby Ray Nichols Iii, FNP-C
	1901 S Shady St, Mountain City, TN 37683-2021
	(423) 727-1150
	(423) 727-1152

Map and Direction

Provider's Profile

Full Name	Bobby Ray Nichols Iii
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	1901 S Shady St, Mountain City, Tennessee
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Bobby Ray Nichols Iii attended and graduated from Lincoln Memorial University Medical Department in 2019

NPI Data:

NPI Number: 1205468923
Provider Enumeration Date: 02/11/2020
Last Update Date: 11/10/2021

Medicare PECOS Information:

PECOS PAC ID: 3274964994
Enrollment ID: I20200513002875

Medical Identifiers

Medical identifiers for Bobby Ray Nichols Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205468923	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	26999 (Tennessee)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Indian Path Community Hospital	Kingsport, TN	Hospital
Wellmont Holston Valley Medical Center	Kingsport, TN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Blue Ridge Medical Management Corporation	9739099441	308

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. Bobby Ray Nichols Iii allows following entities to bill medicare on his behalf.

Entity Name	Blue Ridge Medical Management Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144380833 PECOS PAC ID: 9739099441 Enrollment ID: O20031204000996

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. Bobby Ray Nichols Iii 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
Bobby Ray Nichols Iii, FNP-C Po Box 70403, Johnson City, TN 37614-1703 Ph: (423) 439-4059	Bobby Ray Nichols Iii, FNP-C 1901 S Shady St, Mountain City, TN 37683-2021 Ph: (423) 727-1150

Reviews and Comments

Nurse Practitioner Nurses in Mountain City, TN

Emily B. Mcqueen, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1901 South Shady Street, Mountain City, TN 37683 Phone: 423-727-1103 Fax: 423-727-1140
Christina Faith Stacy, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 222 Oak St, Mountain City, TN 37683 Phone: 423-727-6319 Fax: 423-727-4164
Christine Knowles, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5249 Highway 67 W, Mountain City, TN 37683 Phone: 423-727-7387
Christina Nicole Morton, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1150 Fax: 423-727-1552
Wanda Jarrett, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1150 Fax: 423-727-1151
Mrs. Michelle Lee Manuel, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 237-271-1504 Fax: 423-727-1152

Bobby Ray Nichols Iii, FNP-C - Medicare Nurse Practitioner in Mountain City, TN