Tyson B Nickels, FNP in Kingsport, TN - Medicare Nurse Practitioner

Tyson B Nickels, FNP is a medicare enrolled "Nurse Practitioner - Family" in Kingsport, Tennessee. His current practice location is 1905 American Way, Kingsport, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 390-6335.

Tyson B Nickels is licensed to practice in Tennessee (license number 34307) 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 1982384129.

Contact Information

	Tyson B Nickels, FNP
	1905 American Way, Kingsport, TN 37660-5882
	(423) 390-6335
	Not Available

Map and Direction

Provider's Profile

Full Name	Tyson B Nickels
Gender	Male
Speciality	Nurse Practitioner - Family
Location	1905 American Way, Kingsport, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982384129
Provider Enumeration Date: 07/21/2023
Last Update Date: 10/09/2024

Medicare PECOS Information:

PECOS PAC ID: 9436503984
Enrollment ID: I20231002003106

Medical Identifiers

Medical identifiers for Tyson B Nickels such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982384129	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	0024187654 (Virginia)	Secondary
363L00000X	Nurse Practitioner	34307 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	0024187654 (Virginia)	Secondary
363LF0000X	Nurse Practitioner - Family	34307 (Tennessee)	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. Tyson B Nickels allows following entities to bill medicare on his behalf.

Entity Name	Blue Ridge Medical Management Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144380833 PECOS PAC ID: 9739099441 Enrollment ID: O20031204000996

Entity Name	Wellmont Medical Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780986257 PECOS PAC ID: 8123291739 Enrollment ID: O20111026000909

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. Tyson B Nickels 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
Tyson B Nickels, FNP 1021 W Oakland Ave Ste 310, Johnson City, TN 37604-2192 Ph: (423) 302-6565	Tyson B Nickels, FNP 1905 American Way, Kingsport, TN 37660-5882 Ph: (423) 390-6335

Reviews and Comments

Nurse Practitioner Nurses in Kingsport, TN

Mrs. Cathy A Greenwood, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3136 Winesap Rd, Kingsport, TN 37663 Phone: 423-726-2077
Lauren Ashley Ernst, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1041 E Sullivan St, Kingsport, TN 37660 Phone: 423-279-2777
Kelly A Cox, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2050 Meadowview Pkwy, Kingsport, TN 37660 Phone: 423-230-5000 Fax: 423-230-5613
Sherry Lynn Goode, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-3628 Fax: 423-224-3629
Amanda M Malone, MSN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 Professional Park Pvt Dr, Kingsport, TN 37663 Phone: 423-239-7300
Mrs. Amanda Susan Burns, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 111 W Stone Dr Ste 110, Kingsport, TN 37660 Phone: --
Mary Renee Mcnees, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2300 Pavilion Drive, Kingsport, TN 37660 Phone: 423-765-9655 Fax: 423-979-6333

Tyson B Nickels, FNP - Medicare Nurse Practitioner in Kingsport, TN