Individual provider Active NPI

Joseph Scott Nichols, M.D., M.P.H.

  • Family Medicine Physician
  • Takoma Park, MD
National Provider Identifier
1053602755
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0077593 Issued in MD
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

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
D0077593MDMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.