Active NPI
Thomas M Nichols, CRNA
- Certified Registered Nurse Anesthetist
- Valley, AL
National Provider Identifier
1053369934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1-059468
- Practice address
- 4800 48TH St
Valley, AL 36854-3666 - Phone
- (334) 756-1848
- Fax
- (334) 756-1854
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1-059468 | AL | Primary |
Addresses
Primary practice location
4800 48TH St
Valley, AL 36854-3666
Mailing address
PO Box 661495
Birmingham, AL 35266-1495
Phone (205) 979-5882
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043495579A | Medicaid | GA | |
| 1053369934 | Other | AL | TRICARE |
| 051517975 | Medicaid | AL | |
| P00093299 | Other | AL | RAILROAD MEDICARE |
| 51517975 | Other | AL | BCBSAL PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1053369934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 661495",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352661495",
"telephone_number": "205-979-5882",
"fax_number": "205-979-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 48TH ST",
"city": "VALLEY",
"state": "AL",
"postal_code": "368543666",
"telephone_number": "334-756-1848",
"fax_number": "334-756-1854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "1-059468",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043495579A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1053369934",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051517975",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00093299",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSAL PROVIDER #",
"identifier": "51517975",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.