NPIMap

Individual provider Active NPI

Craig Alan Nicholson, MD

  • Urology Physician
  • Lima, OH
National Provider Identifier
1033223318
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35096239 Issued in OH
Practice address
2751 Fort Amanda Rd
Lima, OH 45805-4805
Phone
(567) 529-9000
Fax
(567) 529-9001
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35096239 OH Primary

Addresses

Primary practice location

2751 Fort Amanda Rd
Lima, OH 45805-4805

Mailing address

2751 Fort Amanda Rd
Lima, OH 45805-4805
Phone (567) 529-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110304000414 OH Practitioner - Urology 3375517600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York Medical College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2751 Fort Amanda Rd
Lima, OH 45805-4805
Phone (567) 529-9000

Hospital & facility affiliations

  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013
  • Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35096239OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Ohio Urological Centers of Excellence, LLC Urology CurrentSince Jan 5, 2023 Accepting new patients
Deaconess Clinic Inc CurrentSince Nov 7, 2022 Accepting new patients
Deaconess Clinic Inc. Urology Current Accepting new patients
West Central Ohio Urological Centers of Excellence, LLC Current Accepting new patients
Deaconess Clinic, Inc Urology CurrentSince Nov 7, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Eric Stockall, MD, PLLC Urology Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4209 Gateway Blvd
Newburgh, IN 47630
Phone (812) 426-9855

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

2751 Fort Amanda Rd
Lima, OH 45805
Phone (419) 855-5119

Interoperability endpoints

  • Direct secure messaging: craignicholson@glhs.allscriptsdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1033223318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 FORT AMANDA RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "567-529-9000",
            "fax_number": "567-529-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 FORT AMANDA RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "567-529-9000",
            "fax_number": "567-529-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35096239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.