Mrs Carly Anne Nichols, OTD OTR/L in Wiggins, MS - Medicare Occupational Therapist Provider

Mrs Carly Anne Nichols, OTD OTR/L is a medicare enrolled "Occupational Therapist" provider in Wiggins, Mississippi. Her current practice location is 1601 Central Ave W, Wiggins, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 716-3196.

Mrs Carly Anne Nichols is licensed to practice in Mississippi (license number OT-4116) 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 1679119036.

Contact Information

	Mrs Carly Anne Nichols, OTD OTR/L
	1601 Central Ave W, Wiggins, MS 39577-2401
	(601) 716-3196
	(601) 974-9919

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Carly Anne Nichols
Gender	Female
Speciality	Occupational Therapist
Location	1601 Central Ave W, Wiggins, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679119036
Provider Enumeration Date: 11/20/2019
Last Update Date: 05/07/2024

Medicare PECOS Information:

PECOS PAC ID: 9133662562
Enrollment ID: I20240613003326

Medical Identifiers

Medical identifiers for Mrs Carly Anne Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679119036	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	OT-4116 (Mississippi)	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. Mrs Carly Anne Nichols allows following entities to bill medicare on her behalf.

Provider Name	Southern Physical Therapy Clinic Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1801370929 PECOS PAC ID: 6103167184 Enrollment ID: O20190402000733

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 Carly Anne 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 Carly Anne Nichols, OTD OTR/L 1620 Highway 11 N Ste C, Picayune, MS 39466-2070 Ph: () -	Mrs Carly Anne Nichols, OTD OTR/L 1601 Central Ave W, Wiggins, MS 39577-2401 Ph: (601) 716-3196

Reviews and Comments

Occupational Therapist in Wiggins, MS

Candace Kemp, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1440 Central Ave E, Wiggins, MS 39577 Phone: 601-928-6700 Fax: 601-928-6731
Devon D Hand, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 Simpson St, Wiggins, MS 39577 Phone: 601-528-1634
Taylor Nicole Lusk, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1436 Central Ave E, Wiggins, MS 39577 Phone: 601-928-1889
Brittney Mahoney, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 711 Hall St, Wiggins, MS 39577 Phone: 601-928-5511 Fax: 601-928-6110
Kelsea Rodriguez, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1601 Central Ave W, Wiggins, MS 39577 Phone: 601-716-3196
Ashton Hermetz Kramer, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1440 Central Ave E, Wiggins, MS 39577 Phone: 601-928-6700

Mrs Carly Anne Nichols, OTD OTR/L - Medicare Occupational Therapist in Wiggins, MS