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BAMBI L NICKELBERRY MD PROFESSIONAL CORPORATION
NPI 1972772655
Family Medicine - Adult Medicine in Inglewood, CA

Active since February 26, 2008
248 N LOCUST ST, INGLEWOOD, CA 90301(310) 673-3737(310) 673-0248 Get Directions Write a Review

NPPES record last updated: June 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Bambi L Nickelberry Md Professional Corporation NPPES

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

BAMBI L NICKELBERRY MD PROFESSIONAL CORPORATION (NPI 1972772655) is a healthcare organization registered as an adult medicine in Inglewood, California and active in the NPI registry since February 2008. The organization lists Bambi Lynn Nickelberry, Director/owner, as its authorized official.

NPPES Registry Identity

NPI1972772655
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameBAMBI L NICKELBERRY MD PROFESSIONAL CORPORATION
Location Address248 N LOCUST STInglewood, CA 90301-1258
Mailing Address248 N Locust StInglewood, CA 90301-1258 · (310) 673-3737 · Fax (310) 673-0248
Phone(310) 673-3737
Fax(310) 673-0248
Organization SubpartNo
Authorized OfficialBambi Lynn NickelberryDirector/owner · (310) 673-3737
Enumeration DateFebruary 26, 2008
Last NPPES UpdateJune 21, 2022
NPPES CertifiedJune 21, 2022
✔ NPI 1972772655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in CA · G466791
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
248 N LOCUST ST, Inglewood, CA 90301
Open in Google Maps ↗

Other Identifiers 1

Medicaid00G466791CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bambi L Nickelberry Md Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bambi L Nickelberry MD Professional Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Bambi Nickelberry, M.D.
Family Practice
NPI 1942383740
11486 BURBANK BLVD
North Hollywood, CA 91601
(818) 505-9991
✔ PECOS✔ Accepts Medicare14 mi

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

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 Bambi L Nickelberry MD Professional Corporation's NPI number?

The NPI number for Bambi L Nickelberry MD Professional Corporation is 1972772655. It was assigned to this organization in the NPPES registry on February 26, 2008.

Where is Bambi L Nickelberry MD Professional Corporation located?

Bambi L Nickelberry MD Professional Corporation is located at 248 N Locust St, Inglewood, CA 90301. The listed phone number is (310) 673-3737.

What is Bambi L Nickelberry MD Professional Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Bambi L Nickelberry MD Professional Corporation enrolled in Medicare?

Yes. Bambi L Nickelberry MD Professional Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bambi L Nickelberry MD Professional Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Bambi L Nickelberry MD Professional Corporation. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bambi L Nickelberry MD Professional Corporation was last updated on June 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.