Ms Stephanie Elizabeth Nicholls, PA-C is a medicare enrolled "Hospitalist" in Kettering, Ohio. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Kettering Independent Medical Group Inc and her current practice location is
3535 Southern Blvd, Kettering, Ohio. You can reach out to her office (for appointments etc.) via phone at
(937) 395-6665.
Ms Stephanie Elizabeth Nicholls is licensed to practice in Ohio (license number 50.006553RX) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104437425.
Provider's Profile
| Full Name | Ms Stephanie Elizabeth Nicholls |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 4 Years |
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| Location | 3535 Southern Blvd, Kettering, Ohio |
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| Accepts Medicare Assignments | Yes. She 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:
- Ms Stephanie Elizabeth Nicholls graduated from nursing school in 2020
NPI Data:
- NPI Number: 1104437425
- Provider Enumeration Date: 08/11/2020
- Last Update Date: 01/11/2021
Medicare PECOS Information:
- PECOS PAC ID: 1153731476
- Enrollment ID: I20201027002920
Medical Identifiers
Medical identifiers for Ms Stephanie Elizabeth Nicholls such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104437425 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | 50.006553RX (Ohio) | Secondary |
| 208M00000X | Hospitalist | 50.006553RX (Ohio) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Kettering Independent Medical Group Inc | 3173710936 | 586 |
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. Ms Stephanie Elizabeth Nicholls 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 |
|---|
Ms Stephanie Elizabeth Nicholls, PA-C
1573 Beaver Ridge Dr,
Kettering, OH 45429-4005
Ph: (937) 903-3471 | Ms Stephanie Elizabeth Nicholls, PA-C
3535 Southern Blvd,
Kettering, OH 45429-1221
Ph: (937) 395-6665 |
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