Scott Richard Nichols, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C6461 Issued in AR

Practice address

3801 Camden Rd # 22
Pine Bluff, AR 71603-4612

Phone

(870) 879-3517

Fax

(870) 879-6049

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Scott R. Nichols M.D. P.a.

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1861624330
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1275577280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD # 22",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-879-3517",
            "fax_number": "870-879-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD # 22",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-879-3517",
            "fax_number": "870-879-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SCOTT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110603001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4535270",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE OF ARKANSAS",
            "identifier": "13838000000",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Day Home Carellc
• New Hope Prosthetics & Orthodics Inc
• New Hope Prosthetics & Orthodics Inc
• Evan N Newbolt, MD
• David Lee Nguyen, M.D.
• Melissa M Nix, LMSW
• David T. Nixon, M.D.
• Robert Benjamin Noble, PA
• Susan Norton
• Farren Norwood, MHPP

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.