Nicole Crumley, PA-C is a medicare enrolled "Physician Assistant - Medical" in Baldwin, Georgia. Her current practice location is
155 Professional Drive, Baldwin, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 776-2368.
Nicole Crumley is licensed to practice in Georgia (license number 11755) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164122214.
Provider's Profile
Full Name | Nicole Crumley |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 155 Professional Drive, Baldwin, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164122214
- Provider Enumeration Date: 03/07/2023
- Last Update Date: 10/28/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668833039
- Enrollment ID: I20230801003744
Medical Identifiers
Medical identifiers for Nicole Crumley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164122214 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 11755 (Georgia) | Secondary |
363AM0700X | Physician Assistant - Medical | 11755 (Georgia) | Primary |
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. Nicole Crumley 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 |
Nicole Crumley, PA-C Po Box 658, Gainesville, GA 30503-0658 Ph: (770) 718-1122 | Nicole Crumley, PA-C 155 Professional Drive, Baldwin, GA 30511-4000 Ph: (706) 776-2368 |
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