1. Home
  2. Directory
  3. Virginia
  4. Joint Base Langley Eustis
  5. Emergency Medicine
  6. NPI Profile

JESSE NICHOLS DO
NPI 1891188892
Emergency Medicine in Joint Base Langley-eustis, VA

Active since March 15, 2015PECOS Enrolled
633D MEDICAL GROUP/SGHC, 77 NEALY AVE, JOINT BASE LANGLEY-EUSTIS, VA 23665(757) 764-6800 Get Directions Write a Review

NPPES record last updated: July 18, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 18, 2019, Jun 13, 2019 (2 updates tracked since 2019).

About Jesse Nichols Do NPPES

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

JESSE NICHOLS DO (NPI 1891188892) is an individual emergency medicine provider in Joint Base Langley-eustis, Virginia, licensed in Ohio (34.012968) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891188892
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJESSE NICHOLSCredential: DO
Location Address633D MEDICAL GROUP/SGHC, 77 NEALY AVEJoint Base Langley-eustis, VA 23665-2040
Mailing Address112 Low StButte, MT 59701-7633
Phone(757) 764-6800
Sole ProprietorNo
Enumeration DateMarch 15, 2015
Last NPPES UpdateJuly 18, 20192 updates tracked since enumeration
✔ NPI 1891188892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in OH · 34.012968✔ Licensed in VA · 0102205683
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
633D MEDICAL GROUP/SGHC, Joint Base Langley-eustis, VA 23665
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesse Nichols Do 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.

Medicare Billing Reassignment

Medicare enrollment records show Jesse Nichols reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Hospital Of Anaconda
1,955 mi
Family Medicine
401 S ALABAMA ST, SUITE 6A
Butte, MT 59701
  • Reassigned Medicare billing, Montana enrollment
  • Also billed through NPI 1538597703 (Montana)
  • 81 clinicians in this Medicare group
NPI 1205239076 (406) 782-2329

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23665 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

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 Jesse Nichols's NPI number?

The NPI number for Jesse Nichols is 1891188892. It was assigned to this individual provider in the NPPES registry on March 15, 2015.

Where is Jesse Nichols located?

Jesse Nichols practices at 633D Medical Group/Sghc 77 Nealy Ave, Joint Base Langley-Eustis, VA 23665. The listed phone number is (757) 764-6800.

What is Jesse Nichols's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jesse Nichols enrolled in Medicare?

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

Which organization bills Medicare for Jesse Nichols's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Nichols reassigns Medicare benefits to Community Hospital Of Anaconda (Butte, MT). The 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 Jesse Nichols's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jesse Nichols accept?

Health plans from Blue Cross and Blue Shield of Montana and PacificSource Health Plans list Jesse Nichols 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.

When was this NPI record last updated?

The NPPES record for Jesse Nichols was last updated on July 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.