Individual provider Active NPI

Chad L. Nichols, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1306933189
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
990 Issued in OK
Practice address
5200 E I 240 Service Rd
Oklahoma City, OK 73135-2607
Phone
(405) 628-6000
Fax
(405) 628-6792
NPI assigned
Oct 5, 2006
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA03727 TX
Physician Assistant 363A00000X 990 OK Primary

Addresses

Primary practice location

5200 E I 240 Service Rd
Oklahoma City, OK 73135-2607

Mailing address

7800 NW 85TH Ter
Oklahoma City, OK 73132-3385

Other identifiers 1

IdentifierTypeStateIssuer
100108590AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071018000062 OK Practitioner - Physician Assistant 2365538659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohh Physicians LLCGroup PAC ID 1759392079, 132 clinicians

Practice addresses (Care Compare)

4050 W Memorial Rd
Oklahoma City, OK 73120-8382

5224 E I 240 Service Rd
Oklahoma City, OK 73135-2607

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohh Physicians South, LLC Past Accepting new patients
Oklahoma Cardiovascular Surgery Assoc. Inc. Past Accepting new patients
Ohh Rural Clinics, LLC. Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1306933189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NW 85TH TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 E I 240 SERVICE RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731352607",
            "telephone_number": "405-628-6000",
            "fax_number": "405-628-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CHAD",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03727",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108590A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.