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KRISTINE B NICHOLS
NPI 1003123449
Specialist/Technologist - Speech-Language Assistant in Phoenix, AZ

Active since September 07, 2010
20402 N 15TH AVE, PHOENIX, AZ 85027(623) 445-4952(623) 445-5079 Get Directions Write a Review

NPPES record last updated: September 7, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kristine B Nichols NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTINE B NICHOLS (NPI 1003123449) is an individual speech-language assistant in Phoenix, Arizona, licensed in Arizona (SLPA6911) and active in the NPI registry since September 2010.

NPPES Registry Identity

NPI1003123449
Entity TypeIndividualFemale
Primary Taxonomy2355S0801X
Provider Legal NameKRISTINE B NICHOLS
Location Address20402 N 15TH AVEPhoenix, AZ 85027-3636
Mailing Address20402 N 15th AvePhoenix, AZ 85027-3636 · (623) 445-4952 · Fax (623) 445-5079
Phone(623) 445-4952
Fax(623) 445-5079
Sole ProprietorNo
Enumeration DateSeptember 7, 2010
✔ NPI 1003123449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Speech-Language AssistantSpeech, Language and Hearing Service Providers
Taxonomy Code2355S0801X
License✔ Licensed in AZ · SLPA6911
20402 N 15TH AVE, Phoenix, AZ 85027
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristine B Nichols is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Kristine Nichols reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Theracare PLLC
9.9 mi
Occupational Therapist
9385 W DONALD DR
Peoria, AZ 85383
  • Reassigned Medicare billing, Arizona enrollment
  • 95 clinicians in this Medicare group
NPI 1962784249 (602) 875-5616
Heartland Therapy, Inc.
25 mi
Home Health
2830 E BROWN RD STE 1
Mesa, AZ 85213
  • Reassigned Medicare billing, Arizona enrollment
  • 50 clinicians in this Medicare group
NPI 1962552547 (602) 875-5616

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGINA LAWRENCE
Licensed Practical Nurse
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
SUSAN E KRANTZ
Speech-Language Pathologist
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
KIMBERLY ANN SHIBATA
Registered Nurse (School)
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
AMBER M BOOTH
Licensed Vocational Nurse
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
SCARLETT GRAUER
Specialist/Technologist (Speech-Language Assistant)
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
JENNIFER TAPLEY
Speech-Language Pathologist
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-4952
HALLE R TUREK
Speech-Language Pathologist
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-5000
JOSSIE CEBREROS
Licensed Practical Nurse
20402 N 15TH AVE
PHOENIX, AZ 85027
Maricopa County (623) 445-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristine Nichols's NPI number?

The NPI number for Kristine Nichols is 1003123449. It was assigned to this individual provider in the NPPES registry on September 7, 2010.

Where is Kristine Nichols located?

Kristine Nichols practices at 20402 N 15th Ave, Phoenix, AZ 85027. The listed phone number is (623) 445-4952.

What is Kristine Nichols's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Speech-Language Assistant, with taxonomy code 2355S0801X.

Is Kristine Nichols enrolled in Medicare?

Yes. Kristine Nichols is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kristine Nichols's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristine Nichols reassigns Medicare benefits to 2 organizations: Theracare PLLC (Peoria, AZ) and Heartland Therapy, Inc. (Mesa, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristine Nichols's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kristine Nichols was last updated on September 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.