Individual provider Active NPI

John M Nichols, MD

  • Obstetrics & Gynecology Physician
  • Nampa, ID
National Provider Identifier
1114906252
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
6371542 Issued in ID
Practice address
9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone
(208) 381-2267
Fax
(208) 381-4314
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5111807-1204 UT
Obstetrics & Gynecology Physician 207V00000X 511807-1204 UT
Obstetrics & Gynecology Physician 207V00000X 6371542 ID Primary

Addresses

Primary practice location

9850 W St Lukes Dr
Nampa, ID 83687-7912

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

3570 W 9000 S
#210
West Jordan, UT 84088-8876
Phone (801) 569-2626

Other practice location 2

1380 E Medical Center Dr Ste 1600
St George, UT 84790-2123
Phone (435) 251-4170

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.nichols@direct.imail.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000656 UT Practitioner - Obstetrics/Gynecology 9133312960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5111807-1204UTMDSpecialist
6371542IDMDObstetrics & Gynecology Physician
511807-1204UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc. CurrentSince Jul 16, 2022 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Dec 1, 2015 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Feb 18, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Feb 18, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
South Valley Women'S Imaging, LLC Specialist Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

1303 N Main St
Ste 3C
Cedar City, UT 84721
Phone (435) 867-7433

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

454 E Medical Way
Heber City, UT 84032
Phone (435) 654-2500

201 W Layton Pkwy
Ste 2B
Layton, UT 84041
Phone (801) 543-6850

900 Round Valley Dr
Ste 200
Park City, UT 84060
Phone (435) 658-7246

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
Ste N1800
St George, UT 84790
Phone (435) 251-4100

1380 E Medical Center Dr
Ste 1600
St George, UT 84790
Phone (435) 251-4150

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1114906252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 W ST LUKES DR",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836877912",
            "telephone_number": "208-381-2267",
            "fax_number": "208-381-4314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3570 W 9000 S",
            "address_2": "#210",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840888876",
            "country_code": "US",
            "telephone_number": "801-569-2626",
            "fax_number": "801-569-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1380 E Medical Center Dr Ste 1600",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847902123",
            "country_code": "US",
            "telephone_number": "435-251-4170",
            "fax_number": "435-251-4151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "5111807-1204",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "511807-1204",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "6371542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.nichols@direct.imail.org",
            "affiliation": "N",
            "address_1": "3570 W 9000 S",
            "address_2": "#210",
            "city": "West Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840888876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.