JESSAMYN NICHOLS (MA, CCC-SLP) – Speech-Language Pathologist, NPI 1316516412

JESSAMYN NICHOLS (MA, CCC-SLP) is a healthcare provider. based in Waterloo, Iowa. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MA, CCC-SLP. They hold a License No. 085663 (IA). The NPI Number for JESSAMYN NICHOLS (MA, CCC-SLP) is 1316516412

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
JESSAMYN NICHOLS (MA, CCC-SLP)
NPI
1316516412
Phone
(319) 291-8100
Address
600 Park Ln
Enumeration Date
22 June 2021
Last Update Date
25 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2016 (10 years ago)
PAC ID
6204378722
Group Practice PAC ID
3870970486
Professional Enrollment ID
I20240611003854
Address ID
IA507025804WA312XXDRXX300

Contacts

Main Contact
optimahcs.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

127 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in IA

Provider Addresses for JESSAMYN NICHOLS (MA, CCC-SLP)

  • 600 Park Ln

    Waterloo, IA 507025200

    Phone: (319) 291-8100

    Type: Location

  • 217 E BREMER AVE

    WAVERLY, IA 506773435

    Phone: (319) 352-4544

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-06-11

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240611003854IQualified Speech Language PathologistIATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870970486View full group profile
NameSpecialtyState
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistNJ
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA
Qualified Speech Language PathologistIA

Reviews

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Frequently asked questions

What unique ID ties claims to JESSAMYN NICHOLS (MA, CCC-SLP)?
NPI 1316516412 is assigned to JESSAMYN NICHOLS (MA, CCC-SLP) under the national enumeration system.
Is JESSAMYN NICHOLS (MA, CCC-SLP) active in the national directory?
JESSAMYN NICHOLS (MA, CCC-SLP)'s public NPI profile is in an active state.
What field does JESSAMYN NICHOLS (MA, CCC-SLP) work in?
You can think of JESSAMYN NICHOLS (MA, CCC-SLP) as practicing within Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for JESSAMYN NICHOLS (MA, CCC-SLP)?
The page summarizes Waterloo, Iowa for JESSAMYN NICHOLS (MA, CCC-SLP); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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