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KATHRYN LOUISE NICKERSON PA-C
NPI 1053031526
Physician Assistant in Winston Salem, NC

Active since September 02, 2022PECOS EnrolledAccepts Medicare Assignment
114 CHARLOIS BLVD, WINSTON SALEM, NC 27103(336) 765-5470(336) 499-5428 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kathryn Louise Nickerson Pa-c NPPES

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

KATHRYN LOUISE NICKERSON PA-C (NPI 1053031526) is an individual physician assistant in Winston Salem, North Carolina, licensed in North Carolina (0010-15673) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, is affiliated with Newton-wellesley Hospital, and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1053031526
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHRYN LOUISE NICKERSONCredential: PA-C
Location Address114 CHARLOIS BLVDWinston Salem, NC 27103-1522
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(336) 765-5470
Fax(336) 499-5428
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 2, 2022
Last NPPES UpdateOctober 29, 2025
NPPES CertifiedOctober 29, 2025
✔ NPI 1053031526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-15673
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
114 CHARLOIS BLVD, Winston Salem, NC 27103
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Other Names 1

Other Name (5)Kathryn Nickerson

Secondary Practice Location 1

Location 1450 Brookline AveBoston, MA 02215-5450 · Phone (617) 632-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathryn Louise Nickerson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193193407
PECOS Enrollment IDI20251209001038
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Newton-Wellesley Hospital

Acute Care Hospitals · Newton, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220101
Location2014 Washington StreetNewton, MA 02462 · Middlesex County
Emergency services Birthing friendly

Brigham And Women's Hospital

Acute Care Hospitals · Boston, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220110
Location75 Francis StreetBoston, MA 02115 · Suffolk County
Emergency services Birthing friendly

Faulkner Hospital-Brigham And Women's

Acute Care Hospitals · Boston, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220119
Location1153 Centre StreetBoston, MA 02130 · Suffolk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. LAURA BEST RAMSAY M.D.
Obstetrics & Gynecology
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
DR. PAMELA ALSTON OLIVER M.D.
Obstetrics & Gynecology
114 CHARLOIS BLVD
WINSTON-SALEM, NC 27103
Forsyth County (336) 765-5470
DR. JALEEMA NANTON SPEAKS MD
Obstetrics & Gynecology
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
DR. MELISSA FAYE MEYER MD
Obstetrics & Gynecology
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
JENNIFER F GREENLY MS, RD, LDN
Dietitian, Registered
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
MCCALL BARNEY
Nurse Practitioner
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
SANDI ELIZABETH HAMILTON MS, RD, LDN
Dietitian, Registered
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470
MS. CHRISTINA UN CEPEDA-CHYR PA-C
Physician Assistant
114 CHARLOIS BLVD
WINSTON SALEM, NC 27103
Forsyth County (336) 765-5470

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 Kathryn Nickerson's NPI number?

The NPI number for Kathryn Nickerson is 1053031526. It was assigned to this individual provider in the NPPES registry on September 2, 2022.

Where is Kathryn Nickerson located?

Kathryn Nickerson practices at 114 Charlois Blvd, Winston Salem, NC 27103. The listed phone number is (336) 765-5470.

What is Kathryn Nickerson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kathryn Nickerson enrolled in Medicare?

Yes. Kathryn Nickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kathryn Nickerson affiliated with any hospitals?

According to CMS data, Kathryn Nickerson is affiliated with Newton-Wellesley Hospital, Brigham And Women's Hospital and Faulkner Hospital-Brigham And Women's.

When was this NPI record last updated?

The NPPES record for Kathryn Nickerson was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.