Mrs Jessica L Nichols, MS, CCC-A is a medicare enrolled "Audiologist" provider in La Porte, Indiana. She graduated from medical school in 1999 and has 25 years of diverse experience with area of expertise as Qualified Audiologist. She is a member of the group practice La Porte Clinic Company Llc and her current practice location is
304 Detroit St, La Porte, Indiana. You can reach out to her office (for appointments etc.) via phone at
(219) 325-3770.
Mrs Jessica L Nichols is licensed to practice in Indiana (license number 23002292A) 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 1972776292.
Healthcare Provider's Profile
Full Name | Mrs Jessica L Nichols |
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Gender | Female |
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Speciality | Qualified Audiologist |
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Experience | 25 Years |
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Location | 304 Detroit St, La Porte, Indiana |
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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:
- Mrs Jessica L Nichols graduated from medical school in 1999
NPI Data:
- NPI Number: 1972776292
- Provider Enumeration Date: 04/08/2008
- Last Update Date: 09/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 7012084627
- Enrollment ID: I20080924000239
Medical Identifiers
Medical identifiers for Mrs Jessica L Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972776292 | NPI | - | NPPES |
000000770974 | Other | IN | ANTHEM |
200387170 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
231H00000X | Audiologist | 23002292A (Indiana) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
La Porte Clinic Company Llc | 0446558357 | 61 |
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. Mrs Jessica L Nichols allows following entities to bill medicare on her behalf.
Provider Name | Indiana University Health La Porte Physicians Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1760593776 PECOS PAC ID: 0345147963 Enrollment ID: O20031212000670 |
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Provider Name | La Porte Clinic Company Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1568829224 PECOS PAC ID: 0446558357 Enrollment ID: O20160408001751 |
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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. Mrs Jessica L 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 |
Mrs Jessica L Nichols, MS, CCC-A 2022 Kelle Dr, Chesterton, IN 46304-8708 Ph: (219) 364-4004 | Mrs Jessica L Nichols, MS, CCC-A 304 Detroit St, La Porte, IN 46350-2497 Ph: (219) 325-3770 |
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