Mr Kenneth Nicley, PA is a medicare enrolled "Physician Assistant" in Maynardville, Tennessee. He went to Lincoln Memorial University Medical Department and graduated in 2013 and has 11 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Summit Medical Group, Pllc and his current practice location is
149 Durham Dr, Maynardville, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(865) 992-2221.
Mr Kenneth Nicley is licensed to practice in Tennessee (license number 2416) 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 1306252598.
Provider's Profile
| Full Name | Mr Kenneth Nicley |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 11 Years |
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| Location | 149 Durham Dr, Maynardville, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Kenneth Nicley attended and graduated from Lincoln Memorial University Medical Department in 2013
NPI Data:
- NPI Number: 1306252598
- Provider Enumeration Date: 07/08/2014
- Last Update Date: 01/21/2015
Medicare PECOS Information:
- PECOS PAC ID: 0143449413
- Enrollment ID: I20140918001192
Medical Identifiers
Medical identifiers for Mr Kenneth Nicley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306252598 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 2416 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Summit Medical Group, Pllc | 2860396330 | 485 |
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. Mr Kenneth Nicley 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 |
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Mr Kenneth Nicley, PA
1225 E Weisgarber Rd, Suite 200,
Knoxville, TN 37909-2604
Ph: (865) 584-4747 | Mr Kenneth Nicley, PA
149 Durham Dr,
Maynardville, TN 37807-2925
Ph: (865) 992-2221 |
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