MS. STEPHANIE ELIZABETH NICHOLLS (NPI# 1104437425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104437425 |
| Entity Type | Individual |
| Full Name | MS. STEPHANIE ELIZABETH NICHOLLS |
| Credential | PA-C |
| Practice Address |
3535 Southern Blvd Kettering OH 45429-1221 |
| Mailing Address |
1573 Beaver Ridge Dr Kettering OH 45429-4005 |
| Practice Telephone | 9373956665 |
| Mailing Telephone | 9379033471 |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | 50.006553RX | OH | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
50.006553RX | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3535 SOUTHERN BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
| 1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
| 1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
| 1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| 1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
| 1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| 1548816697 | Alex Michael Rank | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316197296 | Shahzad Rahim Farukhi | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2008-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851866206 | Bonnie S Campbell | Hospitalist | 33 W Rahn Rd Ste 102, Dayton, OH 45429-2219 | 2018-10-11 |
| 1306325931 | Hamid R Khatibi | Hospitalist | 730 W. Market St., Lima, OH 45801-4667 | 2018-08-14 |
| 1689169666 | Loreto E Dacio Md LLC | Hospitalist | 2931 Parkwalk Dr, Cincinnati, OH 45239-1902 | 2018-06-22 |
| 1699288753 | Bay View Inpatient Services LLC | Hospitalist | 855 N Sandusky Ave, Upper Sandusky, OH 43351-1031 | 2017-11-13 |
| 1295273407 | Matthew Wolschleger | Hospitalist | 262 Hospital Road, Chillicothe, OH 45601 | 2017-02-08 |
| 1982050068 | Incare Health Solutions, LLC. | Hospitalist | 7830 Oh 199, Upper Sandusky, OH 43351 | 2016-05-09 |
| 1891140893 | Trihealth Rehabilitation Hospital, LLC | Hospitalist | 2155 Dana Ave, Cincinnati, OH 45207 | 2016-04-27 |
| 1053653253 | Regency Hospital of Toledo, LLC | Hospitalist | 5220 Alexis Rd, Sylvania, OH 43560-2504 | 2013-03-26 |
| 1952667974 | Raj Penumetsa | Hospitalist | 2750 Pickle Rd Apt 11, Oregon, OH 43616-3935 | 2012-04-03 |
| 1992034680 | Knd Development 59 LLC | Hospitalist | 707 S. Edwin C. Moses Boulevard, Dayton, OH 45417-3462 | 2009-12-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.