William Patrick Nichols, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

25101 Issued in MS

Practice address

970 Lakeland Dr Ste 61
Jackson, MS 39216-4682

Phone

(601) 982-7850

NPI assigned

May 26, 2014

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 identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

University of Mississippi School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians

Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: william.nicholsmd.p1@direct.jacksonheart.nextgenshare.com

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.

• Jackson Heart Clinic. P.a.

  • Cardiovascular Disease Physician
  • Jackson, MS
  • NPI 1659318558
  Medicare reassignment Care Compare group NPD
• St. Dominic Jackson Memorial

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235173691
  Medicare reassignment Care Compare group NPD
• Kings Daughters Medical Center

  • Anesthesiology Physician
  • Brookhaven, MS
  • NPI 1043245368
  Medicare reassignment NPD
• King'S Daughters Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Brookhaven, MS
  • NPI 1881476364
  NPD
• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  NPD
• St Dominic Hospital Crna'S

  • Certified Registered Nurse Anesthetist
  • Jackson, MS
  • NPI 1467682195
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1401062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1306258330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164682",
            "telephone_number": "601-982-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164682",
            "telephone_number": "601-982-7850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "969 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164606",
            "country_code": "US",
            "telephone_number": "601-200-6819",
            "fax_number": "601-200-0166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-26",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "25101",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "25101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09872218",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ST DOM",
            "identifier": "1Q4772",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MED LIC",
            "identifier": "25101",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8855561",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "william.nicholsmd.p1@direct.jacksonheart.nextgenshare.com",
            "affiliation": "N",
            "address_1": "970 Lakeland Dr Ste 61",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Harold Nichols, CRNA
• James R Nichols III, D.O.
• Meghan Elizabeth Nichols, NP
• Michael R Nichols, D.M.D., M.D.
• Todd Applewhite Nichols, MD
• Kayla Leigh Nicholson, PA-C
• Alisha Nicks, PHARMD
• Amanda Gray Nicols, M.D.
• Lee M Nicols, MD
• John Todd Nida, MD

• Interventional Cardiology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Interventional Cardiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.
• 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.