Whitney Wallace Nichols, D.O.
Individual provider Active NPI Family Medicine Physician · Scott City, KS
NPI 1013321728 · NPPES record last updated Dec 29, 2017
Key facts
- NPI
- 1013321728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 05-38325 (KS)
- Practice address
- 201 Albert Ave
Scott City, KS 67871 - Phone
- (620) 872-2187
- Fax
- (620) 872-7193
- NPI assigned
- Jun 20, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Wichita Family Physicians, P.a.
Practice addresses (Care Compare)
8200 W Central Ave
Wichita, KS 67212-3661
8200 W Central Ave
Suite 1
Wichita, KS 67212-9502
Hospital & facility affiliations
- Phoenix Home Care
- Wesley Medical Center
- Via Christi Hospital Wichita St Teresa, Inc
- Ascension Via Christi Hospitals Wichita, Inc.
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170920003066 | KS | Practitioner - Family Practice | 2062639446 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Wichita Family Physicians, P.a. | Family Medicine | Current |
Accepting new patients |
| West Wichita Family Physicians, P.a. | Family Medicine | Current |
Accepting new patients |
Locations
8200 W Central Ave
Wichita, KS 67212
Phone (316) 491-6330
8200 W Central Ave
Ste 4
Wichita, KS 67212
Phone (316) 721-4910
8200 W Central Ave
Ste 1
Wichita, KS 67212
Phone (316) 721-4544
Interoperability endpoints
- whitneyen@scottclinic.gwaydirect.com
- https://fhir4.healow.com/fhir/r4/EJDEBA
- drnichols@scotthosp.securechart.com
- https://fhir4.healow.com/fhir/r4/EJDEBA/Endpoint/EJDEBA
- whitney.nichols@wwfp.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9408294 | KS | |
| Family Medicine Physician | 207Q00000X | 05-38325 | KS | Yes |
Addresses
Primary practice location
201 Albert Ave
Scott City, KS 67871
Mailing address
201 Albert Ave
Scott City, KS 67871
Phone (620) 872-2187
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201171720A | Medicaid | KS |
Other providers in Scott City, KS
- Kendra Lundgren
- Kris Lundgren
- Ryan Christopher Michels
- Mobile Tone, LLC
- Samantha Montgomery
- Bailey Nickel
- Ragen Lee Numrich
- Open Roads Counseling LLC
- Shannon L Plummer
- Proadjuster Chiropractic of Southwest Kansas, L.L.C.
All providers in Scott City, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.