Michael Paul Nickell, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0031075 Issued in OH

Practice address

15708 McConnellsville Rd
Caldwell, OH 43724-9678

Phone

(740) 305-1312

NPI assigned

Jan 11, 2022

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18451/brand/1/csg/1/fhir/r4

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

• Quality Care Associates Urgent Care and Wellness Center, LLC

  • Family Medicine Physician
  • Marietta, OH
  • NPI 1619442837
  Medicare reassignment NPD
• Valeo Medical, PLLC

  • Urgent Care Clinic/Center
  • New Martinsville, WV
  • NPI 1407180888
  Medicare reassignment

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1073264297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 E CROSS ST",
            "city": "SUMMERFIELD",
            "state": "OH",
            "postal_code": "437889516",
            "telephone_number": "740-995-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15708 MCCONNELLSVILLE RD",
            "city": "CALDWELL",
            "state": "OH",
            "postal_code": "437249678",
            "telephone_number": "740-305-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0031075",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN.431204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Douglas Murray, MD
• Alicia Maye Nau, LPN
• Kathryn Nau, RN
• New Beginnings Home Care LLC
• John Kevin Ney, D.M.D.
• Noble Behavioral Health Choices Inc.
• Noble Correctional Institution
• Noble County (Noble County Health Department)
• Noble County (Noble County Home Health Agency)
• Noble County (Noble County Emergency Services)

• Family Nurse Practitioner in Caldwell, OH
• Providers in Caldwell, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.