Mia Nickerson, MD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

5750 Rufe Snow Dr
North Richland Hills, TX 76180-6163

Phone

(682) 207-7233

NPI assigned

Jul 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1073184636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9264 SILVER DOLLAR DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761311922",
            "telephone_number": "951-640-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 RUFE SNOW DR",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761806163",
            "telephone_number": "682-207-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "MIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van Nguyen, PHARM. D.
• Vivian Nguyen
• Vivian Thi Nguyen
• Daniel Seth Nichols, LPC ASSOCIATE
• Karen B Nichols
• Peggy Jeanne Nix, LPC REGISTERED PLAY
• Grace Njie, APRN PMHNP-BC
• Nobility Healthcare Group
• Matthew Nolan
• North Hills Childrens Clinic

• Professional Counselor in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.