Nicks Service

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NICKS SERVICE

Practice address

367 W Broadway St
Idaho Falls, ID 83402-3639

Phone

(208) 523-5060

Fax

(208) 524-7203

NPI assigned

Jul 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Rocky Nichols

Title

Manager

Phone

(208) 523-5060

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicks Service Other name

Locations

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1376743344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023639",
            "telephone_number": "208-523-5060",
            "fax_number": "208-524-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 W BROADWAY ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023639",
            "telephone_number": "208-523-5060",
            "fax_number": "208-524-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKS SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "ROCKY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "208-523-5060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806670000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicks Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Next Steps Therapy LLC
• Lucy Nguyen, LMSW
• Dianne Nichols, LCSW
• Jill Nichols
• Selena Nickel
• Amanda Niebergall, PMHNP
• Diane Rae Nielsen, PA C
• Justin Nielsen
• Justin S. Nielsen, PAC
• Kathryn E Nielsen, NP

• Durable Medical Equipment & Medical Supplies in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.