Tammy R Nichols, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Macks Creek, Missouri. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern Np Associates Llc and her current practice location is
2179 State Highway 73, Macks Creek, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 428-5020.
Tammy R Nichols is licensed to practice in Missouri (license number 2024041853) 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 1730900663.
Provider's Profile
| Full Name | Tammy R Nichols |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 2179 State Highway 73, Macks Creek, Missouri |
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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. |
Medical Education and Training:
- Tammy R Nichols graduated from nursing school in 2024
NPI Data:
- NPI Number: 1730900663
- Provider Enumeration Date: 10/23/2024
- Last Update Date: 11/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 7315472602
- Enrollment ID: I20241122003565
Medical Identifiers
Medical identifiers for Tammy R Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1730900663 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163WG0000X | Registered Nurse - General Practice | 2024041853 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2024041853 (Missouri) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Southern Np Associates Llc | 1557686243 | 46 |
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. Tammy R Nichols allows following entities to bill medicare on her behalf.
| Entity Name | Southern Np Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407257447 PECOS PAC ID: 1557686243 Enrollment ID: O20161214001883 |
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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. Tammy R Nichols 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 |
Tammy R Nichols, NURSE PRACTITIONER 2179 State Highway 73, Macks Creek, MO 65786-8228 Ph: (660) 428-5020 | Tammy R Nichols, NURSE PRACTITIONER 2179 State Highway 73, Macks Creek, MO 65786-8228 Ph: (660) 428-5020 |
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