THEODORE NICHOLSON (M.D.) – Emergency Medicine Physician, NPI 1275590051
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,513 EMERGENCY MEDICINE in GA
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Provider Addresses for THEODORE NICHOLSON (M.D.)
2346 BOWWOOD CT
VILLA RICA, GA 301809733
Phone:
Type: Mailing
Tanner Medical Center, 705, Dixie Street, Carrollton, Carroll County, Georgia, 30117, United States
CARROLLTON, GA 301173818
Phone: (770) 836-9666
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2024-08-20 • Largest payer in this snapshot: ABBVIE INC. ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040115000003 | I | Emergency Medicine | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 166 | 161 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 120 | 107 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 73 | 71 | $0 |
| 99292 | Critical care, each additional 30 minutes | 72 | 26 | $0 |
| 99291 | Critical care, first 30-74 minutes | 37 | 37 | $0 |
Insurance plans in this area (ZIP 30180)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| EMERGENCY MEDICINE | GA | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 329 | 295 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Emergency Medicine, Internal Medicine | GA | |
| Emergency Medicine | GA | |
| Emergency Medicine | AL | |
| Emergency Medicine | NC | |
| Emergency Medicine | OH | |
| - | GA | |
| Emergency Medicine | WY | |
| Emergency Medicine | TN | |
| Emergency Medicine | CO |
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