Individual provider Active NPI

Timothy W Nichols, RPH

  • Pharmacist
  • Taylorsville, KY
National Provider Identifier
1265690762
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
010922 Issued in KY
Practice address
849 Taylorsville Rd
Taylorsville, KY 40071-9771
Phone
(502) 477-2267
Fax
(502) 477-2283
NPI assigned
May 30, 2008
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 010922 KY Primary

Addresses

Primary practice location

849 Taylorsville Rd
Taylorsville, KY 40071-9771

Mailing address

849 Taylorsville Rd
Taylorsville, KY 40071-9771
Phone (502) 477-2267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
010922KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
SCPG Kentucky LLC PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1265690762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 TAYLORSVILLE RD",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719771",
            "telephone_number": "502-477-2267",
            "fax_number": "502-477-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 TAYLORSVILLE RD",
            "city": "TAYLORSVILLE",
            "state": "KY",
            "postal_code": "400719771",
            "telephone_number": "502-477-2267",
            "fax_number": "502-477-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "010922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.