Phillip Todd Nichols, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

0101273372 Issued in VA

Practice address

500 Donnally St
Suite 200
Charleston, WV 25301-1648

Phone

(304) 342-0124

Fax

(304) 340-2204

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WV, VA2 enrollments

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 2

Specialty

Otolaryngology

Education

West Virginia University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, South Hill, VA, CCN 490098
• Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Merit-based Incentive Payment System (MIPS)

Final score

85.74 of 100Reported as group

Quality

74.5

Promoting interoperability

100

Improvement activities

40

Cost

77.96

Merit-based Incentive Payment System (MIPS)

Final score

83.95 of 100Reported as group

Quality

69.91

Promoting interoperability

99

Improvement activities

40

Cost

77.42

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• CMH Physician Services, LLC

  • Internal Medicine Physician
  • South Hill, VA
  • NPI 1194760645

  Otolaryngology

  Medicare reassignment NPD
• CMH Physician Services, LLC

  • Hospitalist Physician
  • South Hill, VA
  • NPI 1386028793
  NPD

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

• Community Memorial Hospital

  • General Acute Care Hospital
  • South Hill, VA
  • NPI 1336103738
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1013091727
  Care Compare affiliation
• Virginia Commonwealth University Health System Authority

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1437175734
  Care Compare affiliation

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1396744652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253261628",
            "telephone_number": "304-342-0124",
            "fax_number": "304-340-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DONNALLY ST",
            "address_2": "SUITE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011648",
            "telephone_number": "304-342-0124",
            "fax_number": "304-340-2204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Buena Vista Cir",
            "address_purpose": "LOCATION",
            "city": "South Hill",
            "state": "VA",
            "postal_code": "239701431",
            "country_code": "US",
            "telephone_number": "434-584-3151",
            "fax_number": "434-584-5543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "PHILLIP",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WV",
            "license": "19053",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "VA",
            "license": "0101273372",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101273372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "040014129",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1157768001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0300079000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7979026",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "550595497023",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis Nichols
• Jaiden Nichols
• James M Nichols, PARAPROFESSIONAL
• Katelyn Nichols
• Morgan Nichols
• Susan Nichols
• Valerie Nichols, LPC
• Regina Nicholson
• Teresa Renee Nickell, COTA/L
• Olivia Nicoloudakis, DO

• Otolaryngology Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Otolaryngology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.