Ms Stephanie Elizabeth Nicholls, PA-C - Medicare Physician Assistant in Kettering, OH

Ms Stephanie Elizabeth Nicholls, PA-C is a medicare enrolled "Hospitalist" in Kettering, Ohio. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Kettering Independent Medical Group Inc and her current practice location is 3535 Southern Blvd, Kettering, Ohio. You can reach out to her office (for appointments etc.) via phone at (937) 395-6665.

Ms Stephanie Elizabeth Nicholls is licensed to practice in Ohio (license number 50.006553RX) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1104437425.

Contact Information

Ms Stephanie Elizabeth Nicholls, PA-C
3535 Southern Blvd,
Kettering, OH 45429-1221
(937) 395-6665
Not Available



Provider's Profile

Full NameMs Stephanie Elizabeth Nicholls
GenderFemale
SpecialityPhysician Assistant
Experience4 Years
Location3535 Southern Blvd, Kettering, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Stephanie Elizabeth Nicholls graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1104437425
  • Provider Enumeration Date: 08/11/2020
  • Last Update Date: 01/11/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1153731476
  • Enrollment ID: I20201027002920

Medical Identifiers

Medical identifiers for Ms Stephanie Elizabeth Nicholls such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104437425NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 50.006553RX (Ohio)Secondary
208M00000XHospitalist 50.006553RX (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Kettering Medical CenterKettering, OHHospital
Grandview And Southview HospitalsDayton, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Kettering Independent Medical Group Inc3173710936586

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Stephanie Elizabeth Nicholls is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Stephanie Elizabeth Nicholls, PA-C
1573 Beaver Ridge Dr,
Kettering, OH 45429-4005

Ph: (937) 903-3471
Ms Stephanie Elizabeth Nicholls, PA-C
3535 Southern Blvd,
Kettering, OH 45429-1221

Ph: (937) 395-6665

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