JACKIE MCNICHOLS (ARNP) – Obstetrics & Gynecology Physician, NPI 1154396562

JACKIE MCNICHOLS (ARNP) is a healthcare provider. based in Omaha, Nebraska. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. 110653 (NE). The NPI Number for JACKIE MCNICHOLS (ARNP) is 1154396562

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
JACKIE MCNICHOLS (ARNP)
NPI
1154396562
Phone
(402) 932-8020
Address
119 N 51ST ST STE 200
Enumeration Date
20 February 2006
Last Update Date
15 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4029911900
Graduation Year
2004 (22 years ago)
PAC ID
2860403169
Group Practice PAC ID
5799750667
Professional Enrollment ID
I20060530000218
Address ID
NE681304661OM16909CTXX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,112 NURSE PRACTITIONER in NE

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Provider Addresses for JACKIE MCNICHOLS (ARNP)

  • 200, North 51st Street, Omaha, Douglas County, Nebraska, 68132, United States

    OMAHA, NE 681322867

    Phone: (402) 932-8020

    Fax: (402) 932-3042

    Mailing address matches the actual address.

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: 2006-05-30

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
I20060530000218INurse PractitionerNETBD

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 68132)

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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: 5799750667View full group profile
NameSpecialtyState
Nurse PractitionerNE
O B S T E T R I C S/ G Y N E C O L O G YNE
-NE
O B S T E T R I C S/ G Y N E C O L O G YNE
Nurse PractitionerNE
O B S T E T R I C S/ G Y N E C O L O G YNE
O B S T E T R I C S/ G Y N E C O L O G YNE
-NE
O B S T E T R I C S/ G Y N E C O L O G YNE
O B S T E T R I C S/ G Y N E C O L O G YNE

Reviews

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Frequently asked questions

What unique ID ties claims to JACKIE MCNICHOLS (ARNP)?
NPI 1154396562 is assigned to JACKIE MCNICHOLS (ARNP) under the national enumeration system.
Is JACKIE MCNICHOLS (ARNP) currently active in the NPI registry?
CMS-published data lists JACKIE MCNICHOLS (ARNP) as an active registrant.
Does JACKIE MCNICHOLS (ARNP) list a primary specialty?
If you are matching referrals, note Obstetrics & Gynecology Physician for JACKIE MCNICHOLS (ARNP). Clinical services aligned with this taxonomy classification.
What location shows for JACKIE MCNICHOLS (ARNP)?
We surface Omaha, Nebraska for JACKIE MCNICHOLS (ARNP) based on available NPPES addresses.
How can I contact JACKIE MCNICHOLS (ARNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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