Theodore Nicholson, MD - Medicare Emergency Medicine in Carrollton, GA

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Theodore Nicholson, MD is a medicare enrolled "Emergency Medicine" physician in Carrollton, Georgia. His current practice location is 705 Dixie St, Carrollton, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 836-9666.

Theodore Nicholson is licensed to practice in Georgia (license number 029920) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275590051.

Contact Information

Theodore Nicholson, MD
705 Dixie St,
Carrollton, GA 30117-3818
(770) 836-9666
Not Available

Map and Direction




Physician's Profile

Full NameTheodore Nicholson
GenderMale
SpecialityEmergency Medicine
Location705 Dixie St, Carrollton, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275590051
  • Provider Enumeration Date: 04/27/2006
  • Last Update Date: 04/28/2010
  Medicare PECOS Information:
  • PECOS PAC ID: 9335040245
  • Enrollment ID: I20040115000003

Medical Identifiers

Medical identifiers for Theodore Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275590051NPI-NPPES
000390288BMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PE0004XEmergency Medicine - Emergency Medical Services 029920 (Georgia)Secondary
207P00000XEmergency Medicine 029920 (Georgia)Primary

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. Theodore Nicholson allows following entities to bill medicare on his behalf.
Entity NameCarrollton Emergency Physicians Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790724672
PECOS PAC ID: 7416860010
Enrollment ID: O20040122001028
Entity NameAdvent Care Systems Of Ocilla, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982227781
PECOS PAC ID: 9032532205
Enrollment ID: O20200909002962

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. Theodore Nicholson 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 AddressPractice Location Address
Theodore Nicholson, MD
2346 Bowwood Ct,
Villa Rica, GA 30180-9733

Ph: () -		Theodore Nicholson, MD
705 Dixie St,
Carrollton, GA 30117-3818

Ph: (770) 836-9666

Reviews and Comments


Emergency Medicine Doctors in Carrollton, GA

Brett Wynn, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 705 Dixie St, Carrollton, GA 30117
Phone: 770-836-9666    
Jesse Mitchell Jr., M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 705 Dixie St, Carrollton, GA 30117
Phone: 770-836-9666    
Nathan Hundley, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 705 Dixie St, Carrollton, GA 30117
Phone: 770-812-9597    
Michael Eckert, DO
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 705 Dixie St, Tanner Health Systems, Emergency Dept, Carrollton, GA 30117
Phone: 770-836-9666    
Richard Whitaker, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 705 Dixie St, Carrollton, GA 30117
Phone: 770-836-9666    
Timothy Paul, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 705 Dixie St, Carrollton, GA 30117
Phone: 770-836-9666    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.