NPIMap

Organization Active NPI

CMN Industries

  • Plastic Surgery Physician
  • Olympia, WA
National Provider Identifier
1144725649
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
00049126 Issued in WA
Legal business name
CMN INDUSTRIES
Practice address
145 Lilly Rd NE Ste 101
Olympia, WA 98506-5028
Phone
(360) 878-9300
NPI assigned
Mar 27, 2018
Last updated
Mar 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Christopher M Nichols, MDNPI 1659477610
Title
Owner
Phone
(360) 878-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 00049126 WA Primary

Addresses

Primary practice location

145 Lilly Rd NE Ste 101
Olympia, WA 98506-5028

Mailing address

145 Lilly Rd NE Ste 101
Olympia, WA 98506-5028
Phone (360) 878-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180410001895 WA Part B Supplier - Clinic/Group Practice 0143583807 Receives reassigned benefits from 6 practitioners
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1144725649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LILLY RD NE STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065028",
            "telephone_number": "360-878-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LILLY RD NE STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065028",
            "telephone_number": "360-878-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMN INDUSTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-878-9300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "00049126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.