Michelle R Nichols, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9801727 Issued in NC

Practice address

213C E Marion St
Pilot MTN, NC 27041-8535

Phone

(336) 368-1070

Fax

(336) 368-1071

NPI assigned

Aug 3, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pilot Medical Associates

  • Family Medicine Physician
  • Pilot MTN, NC
  • NPI 1154322063
  NPD (past) Authorized official
• Wake Forest University Baptist Medical Center Community Physicians

  dba King Family Practice

  • Family Medicine Physician
  • King, NC
  • NPI 1972596211
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457352122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "address_2": "213 C EAST MARION ST",
            "city": "PILOT MTN",
            "state": "NC",
            "postal_code": "270410791",
            "telephone_number": "336-368-1070",
            "fax_number": "336-368-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213C E MARION ST",
            "city": "PILOT MTN",
            "state": "NC",
            "postal_code": "270418535",
            "telephone_number": "336-368-1070",
            "fax_number": "336-368-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9801727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129N0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pilot Medical Associates
• Sidney W Spencer, O.D.

• Family Medicine Physician in Pilot MTN, NC
• Providers in Pilot MTN, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.