Benjamin Francis Nichols

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3079

Phone

(520) 275-3771

NPI assigned

Mar 18, 2024

Sex

Male

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: bnichols172403@direct.ohsu.edu

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1083473391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 E BEVERLY DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165716",
            "telephone_number": "520-275-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393079",
            "telephone_number": "520-275-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "BENJAMIN",
        "middle_name": "FRANCIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Sue Nicholes, DPM
• Justin D Nicholls, PHARMD, BCOP, BCPS
• Larry Michael Nicholls
• Lindsay A Nichols Hughes
• Amanda Rae Nichols, CD(DONA)
• Dane J Nichols, MD
• David S. Nichols, PH.D.
• Deborah Elizabeth Nichols, MS, LPC INTERN
• Elizabeth Claire Nichols, RD
• Emma Elaine Nichols

• Student in an Organized Health Care Education/Training Program in Portland, OR
• Providers in Portland, OR by specialty
• Student in an Organized Health Care Education/Training Program in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.