MR. JUSTIN DOYLE NICHOLSON NP-C
NPI 1457806184
Nurse Practitioner in Blue Ridge, GA

Active since August 23, 2016PECOS EnrolledAccepts Medicare Assignment
101 RIVERSTONE VIS STE 102, BLUE RIDGE, GA 30513(706) 258-4140(706) 258-4141 Get Directions Write a Review

NPPES record last updated: August 19, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 19, 2020, May 11, 2020, Mar 9, 2018 and 2 more (5 updates tracked since 2016).

About Mr. Justin Doyle Nicholson Np-c NPPES

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

MR. JUSTIN DOYLE NICHOLSON NP-C (NPI 1457806184) is an individual nurse practitioner in Blue Ridge, Georgia, licensed in Georgia (RN209728) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Cherokee, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1457806184
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. JUSTIN DOYLE NICHOLSONCredential: NP-C
Location Address101 RIVERSTONE VIS STE 102Blue Ridge, GA 30513-6630
Mailing Address1835 Savoy Dr Ste 300Atlanta, GA 30341-1071 · (706) 258-4140 · Fax (706) 258-4141
Fax(706) 258-4141
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 23, 2016
Last NPPES UpdateAugust 19, 20205 updates tracked since enumeration
NPPES CertifiedAugust 19, 2020
✔ NPI 1457806184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN209728
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN209728 (GA)
101 RIVERSTONE VIS STE 102, Blue Ridge, GA 30513

Other Identifiers 3

Medicaid003202905BGA
OtherG00351AGA · Medicare Ptan
Medicaid003202905AGA

Accepted Insurance

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

Mr. Justin Doyle Nicholson Np-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 ID4486932514
PECOS Enrollment IDI20161025001222
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
731 services418 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
223 services171 patients

Hospital Affiliations CMS Care Compare 4

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

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110008
Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County
Emergency services Birthing friendly

Union General Hospital

Acute Care Hospitals · Blairsville, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110051
Location35 Hospital RoadBlairsville, GA 30512 · Union County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Erlanger Murphy Medical Center

Critical Access Hospitals · Murphy, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number341328
Location3990 East Us Highway 64 AltMurphy, NC 28906 · Cherokee County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30513 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
89%97 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
52%118 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%137 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%131 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
35%55 patients2/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

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

Internal Medicine (Hematology & Oncology)
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Nurse Practitioner
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Pharmacist
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Nurse Practitioner
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Internal Medicine (Hematology & Oncology)
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Nurse Practitioner (Family)
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Nurse Practitioner (Family)
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513
Internal Medicine (Hematology & Oncology)
101 RIVERSTONE VIS STE 102
BLUE RIDGE, GA 30513

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 Justin Nicholson's NPI number?

The NPI number for Justin Nicholson is 1457806184. It was assigned to this individual provider in the NPPES registry on August 23, 2016.

Where is Justin Nicholson located?

Justin Nicholson practices at 101 Riverstone Vis Ste 102, Blue Ridge, GA 30513. The listed phone number is (706) 258-4140.

What is Justin Nicholson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Justin Nicholson enrolled in Medicare?

Yes. Justin Nicholson 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.

What insurance does Justin Nicholson accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Justin Nicholson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Justin Nicholson affiliated with any hospitals?

According to CMS data, Justin Nicholson is affiliated with Northside Hospital Cherokee, Union General Hospital, Northside Hospital and Erlanger Murphy Medical Center.

When was this NPI record last updated?

The NPPES record for Justin Nicholson was last updated on August 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.