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MR. DEREK NATHANIEL NIKOLAUS
NPI 1467248187
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Active since April 18, 2025PECOS Enrolled
743 SPRING ST NE, GAINESVILLE, GA 30501(770) 219-9000 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Mr. Derek Nathaniel Nikolaus NPPES

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

MR. DEREK NATHANIEL NIKOLAUS (NPI 1467248187) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467248187
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. DEREK NATHANIEL NIKOLAUS
Location Address743 SPRING ST NEGainesville, GA 30501-3715
Mailing Address693 Shadden RdJohnson City, TN 37615-4285 · (281) 224-0235
Phone(770) 219-9000
Sole ProprietorYes
Enumeration DateApril 18, 2025
NPPES CertifiedApril 18, 2025
✔ NPI 1467248187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
743 SPRING ST NE, Gainesville, GA 30501
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Derek Nathaniel Nikolaus is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DARRYL E BLALOCK CRNA
Nurse Anesthetist, Certified Registered
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 532-7179
JACOB LEEDEKERKEN
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 219-1200
ANELA D PEARSON AGACNP-BC
Nurse Practitioner (Gerontology)
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 534-2020
DR. SHARANI UMAYANGANI JAYARATNE MD
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 219-1200
JUSTINA LI VEGA PA-C
Physician Assistant (Surgical)
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 533-7288
LAUREN CALLAWAY PHARMD
Pharmacist
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 219-9000
RACHAEL PHLIPOT CAA
Anesthesiologist Assistant
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (770) 532-7179
DR. KEITH EDWIN LEAP II MD
Emergency Medicine
743 SPRING ST NE
GAINESVILLE, GA 30501
Hall County (786) 357-9327

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 Derek Nikolaus's NPI number?

The NPI number for Derek Nikolaus is 1467248187. It was assigned to this individual provider in the NPPES registry on April 18, 2025.

Where is Derek Nikolaus located?

Derek Nikolaus practices at 743 Spring St NE, Gainesville, GA 30501. The listed phone number is (770) 219-9000.

What is Derek Nikolaus's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Derek Nikolaus enrolled in Medicare?

Yes. Derek Nikolaus is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derek Nikolaus was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.