Michael P Nicholson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO-04291 Issued in IA

Practice address

1410 SW Tradition Dr
Ste 120
Ankeny, IA 50023

Phone

(515) 875-9040

Fax

(515) 875-9041

NPI assigned

Jul 23, 2010

Last updated

Jan 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Des Moines University of Osteopathic Medicine and Health Sciences, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidd-Krafft Occupational and Physical Therapy PAGroup PAC ID 1254689169, shared by 3 NPIs, 32 clinicians

The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Iowa Clinic PC

  dba The Iowa Clinic

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1346233178
  Medicare reassignment Care Compare group NPD
• The Iowa Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • West Des Moines, IA
  • NPI 1871451328
  NPD

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1407169097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SW TRADITION DR",
            "address_2": "STE 120",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "50023",
            "telephone_number": "515-875-9040",
            "fax_number": "515-875-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-04291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michaelnicholson@tic.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1410 SW Tradition Dr",
            "address_2": "Ste 120",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sophia Chau Nguyen, PHARMD
• Sylvia Nguyen
• Amabilis Vigaah Ngwa
• Corbin Nichol
• Reagan Nichol, RBT
• Nicole Ferriss, LLC (Future Days)
• Molly Niday
• Nicole Niebuhr
• John Vendelboe Nielsen, RD
• Caroline Noble

• Family Medicine Physician in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.