KIRA NICKOLS (FNP-BC) – Family Nurse Practitioner, NPI 1063239366

KIRA NICKOLS (FNP-BC) is a healthcare provider. based in Timonium, Maryland. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. R192096 (MD). The NPI Number for KIRA NICKOLS (FNP-BC) is 1063239366

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
KIRA NICKOLS (FNP-BC)
NPI
1063239366
Phone
(443) 629-6031
Address
15 BLONDELL CT
Enumeration Date
26 September 2024
Last Update Date
26 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4106254972
Graduation Year
2024 (2 years ago)
PAC ID
1759818974
Group Practice PAC ID
7719882943
Professional Enrollment ID
I20241228000020
Address ID
MD212022102BA301XXSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

6,763 NURSE PRACTITIONER in MD

Provider Addresses for KIRA NICKOLS (FNP-BC)

  • 15 BLONDELL CT

    TIMONIUM, MD 210932003

    Phone: (443) 629-6031

    Type: Mailing

  • 345 SAINT PAUL ST

    BALTIMORE, MD 212022123

    Phone: (410) 332-9000

    Type: Location

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: 2024-12-28

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
I20241228000020INurse PractitionerMDTBD

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 21093)

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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: 7719882943View full group profile
NameSpecialtyState
Diagnostic RadiologyNY
N E U R O L O G YMD
O B S T E T R I C S/ G Y N E C O L O G YMD
-MD
R H E U M A T O L O G YPA
-MD
Radiation OncologyPA
Physician AssistantMD
Nurse PractitionerMD
Diagnostic RadiologyMD

Reviews

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Frequently asked questions

Can I use this page to confirm KIRA NICKOLS (FNP-BC)'s NPI?
Yes. KIRA NICKOLS (FNP-BC) is listed with NPI 1063239366 in the public NPI dataset.
Does the file indicate KIRA NICKOLS (FNP-BC) is practicing under active NPI?
Directory data currently reports KIRA NICKOLS (FNP-BC) as active.
What is KIRA NICKOLS (FNP-BC)'s specialty?
The listing groups KIRA NICKOLS (FNP-BC) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for KIRA NICKOLS (FNP-BC)?
KIRA NICKOLS (FNP-BC)'s geographic hint is Timonium, Maryland in our summary view.
Is the information about KIRA NICKOLS (FNP-BC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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