Active NPI
Joseph Scott Nichols, M.D., M.P.H.
- Family Medicine Physician
- Takoma Park, MD
National Provider Identifier
1053602755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D0077593
- Practice address
- 7000 Carroll Ave Ste 200a
Takoma Park, MD 20912-4437 - Phone
- (301) 578-2388
- Fax
- (855) 612-2683
- NPI assigned
- Apr 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D0077593 | MD | Primary |
Addresses
Primary practice location
7000 Carroll Ave Ste 200a
Takoma Park, MD 20912-4437
Mailing address
7000 Carroll Ave Ste 200a
Takoma Park, MD 20912-4437
Phone (301) 578-2388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Previously, effective Aug 12, 2020 through Aug 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0077593 | MD | MD | Family Medicine Physician |
Interoperability endpoints
- joseph.nichols@884930385608708.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1053602755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000 CARROLL AVE STE 200A",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209124437",
"telephone_number": "301-578-2388",
"fax_number": "855-612-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 CARROLL AVE STE 200A",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209124437",
"telephone_number": "301-578-2388",
"fax_number": "855-612-2683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JOSEPH",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "M.D., M.P.H.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-28",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0077593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.