Individual provider Active NPI

Carter J Nichols, M.D.

  • Ophthalmology Physician
  • Edina, MN
National Provider Identifier
1366418790
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
34419 Issued in MN
Practice address
7450 France Ave S
Suite 100
Edina, MN 55435-4787
Phone
(952) 832-8100
Fax
(952) 832-8176
NPI assigned
Feb 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 34419 MN Primary

Addresses

Primary practice location

7450 France Ave S
Suite 100
Edina, MN 55435-4787

Mailing address

7450 France Ave S
Suite 100
Edina, MN 55435-4787
Phone (952) 832-8100

Other identifiers 7

IdentifierTypeStateIssuer
105073OtherMNPATIENT CHOICE
2F671NIOtherMNBLUE CROSS BLUE SHIELD
23387OtherMNAMERICA'S PPO/TPA
0800014OtherMNMEDICA DUEL SOLUTIONS
960560305008OtherMNPREFERRED ONE
F21442OtherMNHEALTH PARTNERS
0824658OtherMNMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20050525000136 MN Practitioner - Ophthalmology 5698716835

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.52 of 100Reported as group
Quality
80.37
Promoting interoperability
96
Improvement activities
40
Cost
74.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34419MNMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366418790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354787",
            "telephone_number": "952-832-8100",
            "fax_number": "952-832-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354787",
            "telephone_number": "952-832-8100",
            "fax_number": "952-832-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CARTER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "34419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PATIENT CHOICE",
            "identifier": "105073",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2F671NI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO/TPA",
            "identifier": "23387",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA DUEL SOLUTIONS",
            "identifier": "0800014",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "960560305008",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "F21442",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0824658",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.