Amanda Diane Nichols, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21641 Issued in WV

Practice address

3 E Benjamin Dr
New Martinsville, WV 26155-2705

Phone

(304) 455-8080

Fax

(304) 455-8141

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Family Practice

Education

West Virginia University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wetzel County Hospital IncGroup PAC ID 4284065400, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wetzel County Hospital Hospital, New Martinsville, WV, CCN 510072
• Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
• Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
• Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anichols216506@direct.wvuhsdirect.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.

• Wetzel County Hospital, Inc.

  • Family Medicine Physician
  • New Martinsville, WV
  • NPI 1518590033
  Medicare reassignment Care Compare group NPD
• Wetzel County Hospital, Inc.

  • Rural Health Clinic/Center
  • Pine Grove, WV
  • NPI 1245846765
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Washington Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Washington, PA
  • NPI 1639133861
  NPD (past)

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

• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1508160268
  Care Compare affiliation
• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  Care Compare affiliation
• Reynolds Memorial Hospital, Inc

  • General Acute Care Hospital
  • Glen Dale, WV
  • NPI 1144228305
  Care Compare affiliation
• Wetzel County Hospital, Inc.

  • Rural Acute Care Hospital
  • New Martinsville, WV
  • NPI 1376175240
  Care Compare affiliation
• Wheeling Hospital Inc

  • General Acute Care Hospital
  • Wheeling, WV
  • NPI 1104821305
  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1396731683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E BENJAMIN DR",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552705",
            "telephone_number": "304-455-8080",
            "fax_number": "304-455-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E BENJAMIN DR",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552705",
            "telephone_number": "304-455-8080",
            "fax_number": "304-455-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMANDA",
        "middle_name": "DIANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000901",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anichols216506@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 E Benjamin Dr",
            "city": "New Martinsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261552705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anichols216506@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 E Benjamin Dr",
            "city": "New Martinsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261552705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anichols216506@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 E Benjamin Dr",
            "city": "New Martinsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261552705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• New Martinsville Volunteer Fire Department, Inc.
• Darlene Marie Newell, MSW, LGSW
• Tabitha Danielle Newlen
• Robert Lee Newman II
• Ken Nice, MSW, LGSW
• Gary A Nichols, MD
• Janice Elaine Nolan
• Mary Null
• Tamara Joy Oneil
• Nunzio Peter Pagano Sr., DC

• Family Medicine Physician in New Martinsville, WV
• Providers in New Martinsville, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.