Antone M Nichols, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

21627 Issued in MS

Practice address

1723 University Ave Ste B
Oxford, MS 38655-4109

Phone

(662) 290-9091

NPI assigned

Feb 19, 2009

Last updated

Jun 14, 2023By 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

Other names 1

• Dr. Mac Nichols Other name

Medicare fee-for-service enrollment

Enrolled in MS, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anichols133860@ummc.direct-ci.com
• Direct secure messaging: mnichols568412@direct.medicine.duke.edu

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.

• Grenada Emergency Group, LLC

  • Emergency Medicine Physician
  • Grenada, MS
  • NPI 1194388082
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  MS

  Medicare reassignment NPD
• Be Well Mississippi LLC

  • Obesity Medicine (Internal Medicine) Physician
  • Oxford, MS
  • NPI 1518670850
  NPD Authorized official
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Medical Center-Grenada Specialty Clinic

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1295974988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 UNIVERSITY AVE STE B",
            "address_2": "BOX 315",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-290-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 UNIVERSITY AVE STE B",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386554109",
            "telephone_number": "662-290-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ANTONE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-19",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "21627",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "MS",
            "license": "21627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAC",
            "last_name": "NICHOLS",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Natalie Miller Nelson, NP
• Rhagen Nelson
• Jessica-Lauren Roberts Newby, RDN, LD, IBCLC
• Macy Lillian Newcomb, BA
• My Nguyen, DNP-FNP
• Joli Nichols, OT
• Sandy Nix
• Danna Kathryn Nobile, DMD
• Jennifer Noe
• Beth Norris, FNP-BC

• Emergency Medicine Physician in Oxford, MS
• Providers in Oxford, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.