Samuel Walker Nickles, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

TL32770 Issued in SC

Practice address

2890 Tricom St
North Charleston, SC 29406-9171

Phone

(843) 797-6600

Fax

(843) 820-1440

NPI assigned

Jun 22, 2010

Last updated

Sep 16, 2015By the provider in NPPES

Sex

Male

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 SC

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

UrologyAlso: General Surgery

Education

Medical University of South Carolina College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmetto Adult and Childrens Urology PAGroup PAC ID 1254400021, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Colleton Medical Center Hospital, Walterboro, SC, CCN 420030
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
• Hampton Regional Medical Center Hospital, Varnville, SC, CCN 420072
• Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

Merit-based Incentive Payment System (MIPS)

Final score

83.96 of 100Reported as group

Quality

65.18

Promoting interoperability

100

Improvement activities

40

Cost

81.34

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Palmetto Adult and Childrens Urology PA

  • Urology Physician
  • North Charleston, SC
  • NPI 1467440644
  Medicare reassignment Care Compare group NPD

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

• Bon Secours St. Francis Xavier Hospital Inc.

  dba Roper St. Francis Intensivist Services

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation
• Hampton Regional Medical Center

  • Rural Acute Care Hospital
  • Varnville, SC
  • NPI 1487651949
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  dba Roper St. Francis Intensivist Services

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation
• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation
• Walterboro Community Hospital, Inc.

  dba HCA Healthcare Colleton Hospital

  • General Acute Care Hospital
  • Walterboro, SC
  • NPI 1376597997
  Care Compare affiliation

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1275854457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "SAMUEL",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "TL32770",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "TL32770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NHC Homecare-South Carolina LLC (NHC HomeCare-Low Country)
• Wendy Nichols
• Rebecca Nickell, PHARMD, RPH
• Katie Gardner Nickerson, PA-C
• Patricia M Nicklas, DDS
• Carrie S Niemann, D.D.S
• Jeffrey Gerard Nigro, LISW-CP
• Elizabeth Ninneman, DPT
• Bradley Nirenblatt
• Nitesh Gandhi, LLC

• Urology Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.