Courtney R Nichols, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2017042162 Issued in MO

Practice address

1611 S Baltimore St Ste a
Kirksville, MO 63501-4519

Phone

(660) 665-7575

Fax

(660) 665-7576

NPI assigned

Dec 15, 2017

Sex

Female

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 MO

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 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Regional Medical Center Hospital, Kirksville, MO, CCN 260022
• Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025
• University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
• Direct secure messaging: courtney.nichols.p1@direct.cfmkv.nextgenshare.com

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.

• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  Medicare reassignment Care Compare group NPD
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD
• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Kirksville, MO
  • NPI 1447789300
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Curators of the University of Missouri

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1174597892
  Care Compare affiliation
• Curators of the University of Missouri

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  Care Compare affiliation
• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  Care Compare affiliation
• Kirksville Missouri Hospital Company, LLC

  • General Acute Care Hospital
  • Kirksville, MO
  • NPI 1104899442
  Care Compare affiliation

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235645151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "660-665-7575",
            "fax_number": "660-665-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S BALTIMORE ST STE A",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014519",
            "telephone_number": "660-665-7575",
            "fax_number": "660-665-7576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29934 July Rd",
            "address_purpose": "LOCATION",
            "city": "LA Plata",
            "state": "MO",
            "postal_code": "635493129",
            "country_code": "US",
            "telephone_number": "660-332-7676",
            "fax_number": "660-665-7576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "COURTNEY",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2007025283",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017042162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Newberry, LPC
• Hayley Powell Newman, MSN, APRN
• Teresa Huynh Ngo, DO
• Amber Phuong-Anh Nguyen
• Matthew Nguyen, DO
• Katya Nichols
• Kaitlyn Nickels, DO
• Laura E Nickelson, MA, LPC
• Shelli Lynn Nicoli, LPN
• Gabrielle M Nielsen

• Family Nurse Practitioner in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.