MS. SUSAN KAY NICHOLSON (NPI# 1275546020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275546020 |
| Entity Type | Individual |
| Full Name | MS. SUSAN KAY NICHOLSON |
| Other Name | MS. SUSAN KAY SMITLEY |
| Credential | P.A. |
| Practice Address |
915 N Grand Blvd 111-jc/gi Saint Louis MO 63106-1621 |
| Practice Telephone | 3146524100 |
| Practice Fax Number | 3142897035 |
| Mailing Telephone | 3146524100 |
| Mailing Fax Number | 3142897035 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588984710 | Susan Nicholson | Pharmacist | 232 Roosevelt Ave, Enumclaw, WA 98022-8242 | 2010-06-10 |
| 1568522811 | Susan Paige Nicholson | Nurse Anesthetist, Certified Registered | 412 Tinkerbell Rd, Chapel Hill, NC 27517-2337 | 2006-12-09 |
| 1104286319 | Susan Nicholson | Massage Therapist | 700 Empire Blvd, Rochester, NY 14609-5948 | 2016-03-01 |
| 1043698897 | Susan Jennifer Nicholson | Behavioral Analyst | N27w23953 Paul Rd, Suite 206, Pewaukee, WI 53072-6242 | 2015-05-13 |
| 1629418587 | Susan Nicholson | Internal Medicine | 1300 York Ave, Lc-423, New York, NY 10065-4805 | 2013-06-25 |
| 1437328721 | Susan Nicholson | Developmental Therapist | 103 Johnson St, Lynn, MA 01902-4001 | 2008-02-21 |
| 1023232626 | Susan Cummings Nicholson | Social Worker | 703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576 | 2007-04-13 |
| 1558480756 | Susan Sanger Nicholson | Nurse Practitioner | 2030 Mountain View Ave, Suite 400, Longmont, CO 80501-3182 | 2007-03-28 |
| Street Address |
915 N GRAND BLVD 111-JC/GI |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63106-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115480 | Jamie Lynn Swanson | Physician Assistant | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2005-06-21 |
| 1821602756 | Courtney Kay Duberry | Optometrist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-09-08 |
| 1043820053 | Kathryn Marie Storm | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-08-04 |
| 1326657230 | Rebecca Oluwafunmito Babalola | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-27 |
| 1639787328 | Justin Clarke Liedke | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-19 |
| 1639796899 | Taylor Anderson | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-02 |
| 1427675800 | Lauren Elizabeth Smith | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-01 |
| 1427675925 | Christa Marie Stoutenborough | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-30 |
| 1992322739 | Alexia Lambos Georges | Perfusionist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-27 |
| 1912522210 | Meaghan Elizabeth Lecture | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770027997 | Superior Manor of Downtown LLC | Assisted Living Facility | 1501 Clinton St., St Louis, MO 63106 | 2016-12-07 |
| 1811361454 | James Preston Jr. | Pharmacist | 915 N. Grand Vlvd, Pharmacy Dept., John Cochran Va Medical Center, Saint Louis, MO 63106 | 2015-11-19 |
| 1245656354 | Julie Marie Albsmeyer | Physician Assistant | 915 North Grand 111-jc-gi, John Cochran Va Hospital, St. Louis, MO 63106 | 2014-03-13 |
| 1932523230 | Cathy Yeung | Registered Nurse | 715 N Grand Blvd., St Louis, MO 63106 | 2014-02-07 |
| 1902149388 | Amanda Foley | Doula | 4056 Humphrey Street, Saint Louis, MO 63106 | 2013-04-03 |
| 1942569876 | Cornelia Charles | Internal Medicine | 915 Norh Grand Blvd, Saint Louis, MO 63106 | 2012-05-12 |
| 1124334396 | Kasandra Ann Tinajero | Registered Nurse | 915 N. Grand Blvd., St. Louis, MO 63106 | 2010-08-26 |
| 1366673931 | Cassandra Vernetta Talbert | Social Worker | 915 N. Grand., 122/jc Social Work Dept. V.a. Medical Center, St. Louis, MO 63106 | 2009-07-30 |
| 1497910707 | Robert Louis Tillman | Pharmacy Technician | 915 N Grand Ave, St. Louis, MO 63106 | 2008-07-25 |
| 1861676686 | Bradley Dean Overmeyer | Social Worker | 915 N Grand Blvd., Social Work Service, St. Louis, MO 63106 | 2007-12-28 |
| Find all providers in zip 63106 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779341 | Andrew Hecht | Physician Assistant | 13131 Tesson Ferry Rd Ste 105, Saint Louis, MO 63128-3887 | 2020-10-30 |
| 1396352860 | Alexis Lindsey | Physician Assistant | 5629 Bischoff Ave, Saint Louis, MO 63110-2929 | 2020-09-28 |
| 1942824339 | Jett Elena Mcguire | Physician Assistant | 2200 Locust St Apt 506, Saint Louis, MO 63103-1532 | 2020-06-02 |
| 1356965602 | Katherine Anne Hill | Physician Assistant | 3619 Whispering Ridge Ln, Saint Louis, MO 63129-2247 | 2020-06-02 |
| 1326669516 | Kayla Bergmann | Physician Assistant | 58 W Glendale Rd, Saint Louis, MO 63119-4054 | 2020-04-29 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1477172237 | Allison Mcniell | Physician Assistant | 3853 Mcdonald Ave # 1f, Saint Louis, MO 63116-4716 | 2020-04-13 |
| 1922627728 | Allissa Speiser | Physician Assistant | 3437 Caroline St Ste 3082, Saint Louis, MO 63104-1111 | 2020-04-11 |
| 1578182564 | Alexander Charles Greff | Physician Assistant | 6416 Oakland Ave Apt 306, Saint Louis, MO 63139-3226 | 2020-04-10 |
| 1043839061 | Andrew Chida | Physician Assistant | 2050 Lafayette Ave Apt 1e, Saint Louis, MO 63104-2529 | 2020-04-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63106 |
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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.