Kathryn Nicholas (NPI# 1093004400, PAC ID# 4082863295) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1093004400 |
| PAC ID by PECOS | 4082863295 |
| Professional Enrollment ID | I20170609000733 |
| Full Name | Kathryn Nicholas |
| Organization Legal Name | LAKELAND RADIOLOGISTS, PA |
| Address |
969 Lakeland Dr Jackson MS 39216-4606 |
| Phone Number | 6012002000 |
| Gender | F |
| Medical School | GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 4183683089 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| 250031 | MERIT HEALTH RIVER REGION |
| 250097 | SOUTHWEST MS REGIONAL MEDICAL CENTER |
| 250043 | NESHOBA COUNTY GENERAL HOSPITAL |
| 250138 | MERIT HEALTH RIVER OAKS |
| Address | Phone | Organization |
|---|---|---|
| 969 Lakeland Dr, Jackson, MS 39216-4606 | 6012002000 | LAKELAND RADIOLOGISTS, PA |
| 215 Marion Ave, Mccomb, MS 39648-2705 | 6012491553 | LAKELAND RADIOLOGISTS, PA |
| Organization Legal Name | LAKELAND RADIOLOGISTS, PA |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Lewis Lamar | Diagnostic Radiology | Lakeland Radiologists, Pa | 72 N Crest Rd, Chattanooga, TN 37404-1828 |
| Edgar D Barham | Diagnostic Radiology | Lakeland Radiologists, Pa | 1026 N Flowood Dr, Flowood, MS 39232-9532 |
| James D Thomasson Jr. | Diagnostic Radiology | Lakeland Radiologists, Pa | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Gulliermo J Tanaka | Interventional Radiology | Lakeland Radiologists, Pa | 106 Highland Way, Madison, MS 39110-6929 |
| Marcus Presley | Diagnostic Radiology | Lakeland Radiologists, Pa | 2100 Hwy 61 N, Vicksburg, MS 39183-8211 |
| Benton C Parker | Diagnostic Radiology | Lakeland Radiologists, Pa | 106 Highland Way, Madison, MS 39110-6929 |
| Bryan S Lantrip | Diagnostic Radiology | Lakeland Radiologists, Pa | 106 Highland Way, Madison, MS 39110-6929 |
| Yong W Kim | Diagnostic Radiology | Lakeland Radiologists, Pa | 106 Highland Way, Madison, MS 39110-6929 |
| Brooks Barham | Diagnostic Radiology | Lakeland Radiologists, Pa | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| William Forrest Carson | Diagnostic Radiology | Lakeland Radiologists, Pa | 106 Highland Way, Madison, MS 39110-6929 |
| Street Address |
969 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip | 39216-4606 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Smith | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Amber Lynne Goodman | Physician Assistant | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Gabriel M Zevallos | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Deidra Thompson | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jonathan Davison Reves | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jana P Cline | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle Hughes | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| James E Roberts Jr. | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle V Taylor | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jenna Elizabeth Clark | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark O Rester | Psychiatry | 1225 N State St, Jackson, MS 39216 | |
| Jasmine Martin Smith | Physical Therapy | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Lula Johnson | Nurse Practitioner | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Olivia Mccay | Registered Dietitian Or Nutrition Professional | Nutrition Systems Wellness LLC | 603 Duling Ave, Suite 207, Jackson, MS 39216-4009 |
| Nosratollah Ghaemmaghami | Internal Medicine | 381 Medical Dr, Jackson, MS 39216-4118 | |
| Julie P Wyatt | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Nancy H Goldman | Certified Clinical Nurse Specialist (cns) | 3000 Old Canton Rd, Suite 465, Jackson, MS 39216-4225 | |
| Louis Wise Jr. | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Thomas H Cabell | Ophthalmology | 3000 Old Canton Rd, Suite 405, Jackson, MS 39216-4234 | |
| Albert T Williams | Ophthalmology | A.terrel Williams, Md, Pllc | 3000 Old Canton Rd, Suite 305, Jackson, MS 39216-4245 |
| Find all physicians in zip 39216 | |||
| City | JACKSON |
| Zip Code | 39216 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | JACKSON + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Kathryn Nicholas.
| 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.