MRS. LEE SHIN NICHOLSON (FNP-BC) – Family Nurse Practitioner, NPI 1336364843
Family Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
6,767 NURSE PRACTITIONER in MD
Provider Addresses for MRS. LEE SHIN NICHOLSON (FNP-BC)
2101 E JEFFERSON ST
KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD 208524908
Phone: (301) 816-2424
Type: Mailing
10810 CONNECTICUT AVE
KAISER PERMANENTE KENSINGTON MEDICAL CENTER
KENSINGTON, MD 208952138
Phone: (301) 929-7100
Type: Location
655 Watkins Mill Rd
Gaithersburg, MD 208793301
Phone: (240) 632-4293
Type: Location
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 207557081
Phone:
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: 2009-02-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20071231000274 | I | Nurse Practitioner | MD | TBD |
| I20090223000529 | I | Nurse Practitioner | DC | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 20852)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MD | |
| - | MD | |
| Internal Medicine | VA | |
| Family Practice | VA | |
| Family Practice | VA | |
| - | MD | |
| - | MD | |
| Family Practice | WV | |
| - | GA | |
| - | MD |
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