Kristie Beth Nichols, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD435394 Issued in PA

Practice address

1100 E Hector St
Suite 105
Conshohocken, PA 19428-2374

Phone

(610) 828-2608

Fax

(610) 828-0102

NPI assigned

Dec 14, 2006

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

Enrolled in NC

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

Specialty

Family Practice

Education

State University of Ny Upstate Medical University, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Samg Inc

  • Primary Care Clinic/Center
  • Plymouth Meeting, PA
  • NPI 1760103881
  NPD (past)
• Prsca Medical Group PC

  • Family Medicine Physician
  • Walnut Creek, CA
  • NPI 1518782234

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1154483501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E HECTOR ST",
            "address_2": "SUITE 105",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282374",
            "telephone_number": "610-828-2608",
            "fax_number": "610-828-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E HECTOR ST",
            "address_2": "SUITE 105",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282374",
            "telephone_number": "610-828-2608",
            "fax_number": "610-828-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KRISTIE",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD435394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Natko, RD, LDN
• Niki Athanasia Nazirides
• Madelyn Neeld
• Neemi Lama Sherpa LLC
• Anh Nguyen, PHARMD
• Nicholson Medical Associates,P.C.
• James Joseph Nicholson, D.O.
• Rose Niklewicz
• Peter Chien Shin Ning, M.D.
• Lisa M. Nocera, M.D.

• All providers in Conshohocken, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.