Individual provider Active NPI

Lawrence S Nichols III, D.C.

  • Chiropractor
  • Marion, AR
National Provider Identifier
1033110804
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1297 Issued in AR
Practice address
2696 Hwy 77 S
Marion, AR 72364-2373
Phone
(870) 739-2500
Fax
(870) 739-4979
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1297 AR Primary

Addresses

Primary practice location

2696 Hwy 77 S
Marion, AR 72364-2373

Mailing address

2696 Hwy 77 S
Marion, AR 72364-2373
Phone (870) 739-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519001123 AR Practitioner - Chiropractic 8325089238 Practice locations: Marion, AR

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2696 Hwy 77 S
Marion, AR 72364-2373

2696 State Hwy 77 S
Marion, AR 72364-2373
Phone (870) 739-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1033110804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 HWY 77 S",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642373",
            "telephone_number": "870-739-2500",
            "fax_number": "870-739-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 HWY 77 S",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642373",
            "telephone_number": "870-739-2500",
            "fax_number": "870-739-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "LAWRENCE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.