Nichole S Supple (NPI# 1871805341, PAC ID# 5890017503) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1871805341 |
| PAC ID by PECOS | 5890017503 |
| Professional Enrollment ID | I20181108001404 |
| Full Name | Nichole S Supple |
| Organization Legal Name | ERX GROUP LLC |
| Address |
163 E Tollison St Baxley GA 31513-0120 |
| Phone Number | 9123679841 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 9335037571 |
| Number of Group Practice Members | 27 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110125 | FAIRVIEW PARK HOSPITAL |
| 110071 | APPLING HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 163 E Tollison St, Baxley, GA 31513-0120 | 9123679841 | ERX GROUP LLC |
| Organization Legal Name | ERX GROUP LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rogelio L Carrera | Emergency Medicine | Erx Group LLC | 3 E Benjamin Dr, New Martinsville, WV 26155-2705 |
| Khadijatu E Allen | Internal Medicine | Erx Group LLC | 302 S Wayne St, Alma, GA 31510-2922 |
| James M Seward | Family Medicine | Erx Group LLC | 117 Kite Rd, Swainsboro, GA 30401-3231 |
| Wiley Wilson | Pediatric Medicine | Erx Group LLC | 117 Kite Rd, Swainsboro, GA 30401-3231 |
| Richard C Houck | Emergency Medicine | Erx Group LLC | 3 E Benjamin Dr, New Martinsville, WV 26155-2705 |
| Mark A Foppe | Emergency Medicine | Erx Group LLC | 117 Kite Rd, Swainsboro, GA 30401-3231 |
| Vijay K Mahathre | Emergency Medicine | Erx Group LLC | 117 Kite Rd, Swainsboro, GA 30401-3231 |
| Neal W Rehberg | Family Medicine | Erx Group LLC | 3 E Benjamin Dr, New Martinsville, WV 26155-2705 |
| David L Turfler | Emergency Medicine | Erx Group LLC | 117 Kite Rd, Swainsboro, GA 30401-3231 |
| Joseph Hugo Duvert | Internal Medicine | Erx Group LLC | 3 E Benjamin Dr, New Martinsville, WV 26155-2705 |
| Street Address |
163 E TOLLISON ST |
| City | BAXLEY |
| State | GA |
| Zip | 31513-0120 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Josefina Y Abendan | Pediatric Medicine | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Mary K Mcmahan | Internal Medicine | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Charles W Brown | Diagnostic Radiology | South Georgia Radiology Associates LLC | 163 E Tollison St, Baxley, GA 31513-0120 |
| Spencer M Paterson | Interventional Pain Management | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Michael K Collins | Diagnostic Radiology | South Georgia Radiology Associates LLC | 163 E Tollison St, Baxley, GA 31513-0120 |
| Royce M Cannington Iii | Diagnostic Radiology | South Georgia Radiology Associates LLC | 163 E Tollison St, Baxley, GA 31513-0120 |
| Manuel B Cuesta | Neurology | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Errol G Graham | Internal Medicine | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Carl L Stalvey | Diagnostic Radiology | South Georgia Radiology Associates LLC | 163 E Tollison St, Baxley, GA 31513-0120 |
| Rebecca A Clark | Physician Assistant | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Beth E Smith | Certified Registered Nurse Anesthetist | The Baxley and Appling County Hospital Authority | 301 E Tollison, Baxley, GA 31513-0120 |
| Orlando V Fernando | Internal Medicine | The Baxley and Appling County Hospital Authority | 163 E Tollison St, Baxley, GA 31513-0120 |
| Wayne Stewart | Diagnostic Radiology | South Georgia Radiology Associates LLC | 163 E Tollison St, Baxley, GA 31513-0120 |
| John Edward Crane | Obstetrics/gynecology | The Baxley and Appling County Hospital Authority | 654 S Main St, Baxley, GA 31513-0124 |
| Ronald Stephen Reagin | Podiatry | 656 S Main St, Baxley, GA 31513-0126 | |
| Janey B Britt | Nurse Practitioner | The Baxley and Appling County Hospital Authority | 105 E Tollison St, Baxley, GA 31513-0149 |
| Matthew Randall Hodges | Nurse Practitioner | The Baxley and Appling County Hospital Authority | 105 E Tollison St, Baxley, GA 31513-0149 |
| Crystal D Bright | Family Medicine | The Baxley and Appling County Hospital Authority | 105 E Tollison St, Suite D, Baxley, GA 31513-0150 |
| Greg L Williams | Nurse Practitioner | Appling Family Total Healthcare, P.C. | 950 S Main St, Suite 2, Baxley, GA 31513-0161 |
| Kimberly Dawn Williams | Nurse Practitioner | Appling Family Total Healthcare, P.C. | 950 S Main St, Suite 2, Baxley, GA 31513-0161 |
| Find all physicians in zip 31513 | |||
| City | BAXLEY |
| Zip Code | 31513 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | BAXLEY + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Nichole S Supple.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.