Beverly Nichols

Primary specialty

SpecialistTaxonomy code 174400000X

License

9569L001 Issued in NY

Practice address

12510 Queens Blvd
Kew Gardens, NY 11415-1519

Phone

(718) 459-5592

Fax

(718) 459-6047

NPI assigned

Nov 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Beverly's Home Health Care Inc

  • Home Health Agency
  • Kew Gardens, NY
  • NPI 1750453130

  Specialist

  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1255403242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 QUEENS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151519",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12510 QUEENS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151519",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "BEVERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-12-13",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "NY",
            "license": "9569L001",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NY",
            "license": "9569L001",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "9569L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01761260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mojgan Neman-Kuighadush, M.D.
• New Homestead Home for Adults Inc
• New York Medical & Diagnostic Center Inc
• New York Medical and Diagnostic Center
• New York State Neuropsychological State of Mind PC
• Jessica Karoline Nikiforidis, M.A., CCC-SLP
• Aleksandr Niyazov
• Peter R Niyazov, PHARMD
• Noah D Freedman MD PC (Psych Choices of the Delaware Valley)
• Northeast Insomnia & Sleep Medicine,PLLC

• Specialist in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.