Individual provider Active NPI

Michael Allison Nichols, M.D.

  • Radiation Oncology Physician
  • Wilmington, NC
National Provider Identifier
1467628644
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2008-00559 Issued in NC
Practice address
1988 S 16TH St
Wilmington, NC 28401-6647
Phone
(910) 251-1839
Fax
(910) 251-8286
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 2008-00559 NC Primary

Addresses

Primary practice location

1988 S 16TH St
Wilmington, NC 28401-6647

Mailing address

PO Box 4574
Wilmington, NC 28406-1574
Phone (910) 251-1839

Other practice location 1

545 Ocean Hwy W
Supply, NC 28462-4047
Phone (910) 754-4716

Other practice location 2

2131 S 17th St
Wilmington, NC 28401-7407
Phone (910) 342-3004

Other practice location 3

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 641-8220

Other practice location 4

1988B S 16th St
Wilmington, NC 28401-6647
Phone (910) 662-8440

Other practice location 5

1988A S 16th St
Wilmington, NC 28401-6647
Phone (910) 662-8440

Other practice location 6

151 Scotts Hill Medical Dr
Wilmington, NC 28411-7983
Phone (910) 662-8440

Other identifiers 1

IdentifierTypeStateIssuer
149RUOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20080711000214 NC Practitioner - Radiation Oncology 5991877607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Carolina Radiation Oncology PLLCGroup PAC ID 1153322631, 11 clinicians

Practice addresses (Care Compare)

1988 S 16TH St
Wilmington, NC 28401-6647
Phone (910) 662-8440

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • J Arthur Dosher Memorial Hospital Hospital, Southport, NC, CCN 341327

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-00559NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Radiation Oncology, PLLC CurrentSince Jul 21, 2008 Accepting new patients
New Hanover Regional Medical Center PastSince Jul 21, 2008 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Past Accepting new patients

Locations

200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578

545 Ocean Hwy W
Supply, NC 28462
Phone (910) 253-3380

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

1988 S 16th St
#B
Wilmington, NC 28401
Phone (910) 662-8440

1988 S 16th St
#A
Wilmington, NC 28401
Phone (910) 662-8440

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

1988 S 16th St
Wilmington, NC 28401
Phone (910) 251-1839

Interoperability endpoints

  • Direct secure messaging: mpapagikos@ccradonc.direct.varian.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1467628644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4574",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284061574",
            "telephone_number": "910-251-1839",
            "fax_number": "910-251-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1988 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016647",
            "telephone_number": "910-251-1839",
            "fax_number": "910-251-8286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Ocean Hwy W",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284624047",
            "country_code": "US",
            "telephone_number": "910-754-4716",
            "fax_number": "910-754-4530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-342-3004",
            "fax_number": "910-342-3097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Whiteville",
            "state": "NC",
            "postal_code": "284723634",
            "country_code": "US",
            "telephone_number": "910-641-8220",
            "fax_number": "910-641-8226",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1988B S 16th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016647",
            "country_code": "US",
            "telephone_number": "910-662-8440",
            "fax_number": "910-251-8286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1988A S 16th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016647",
            "country_code": "US",
            "telephone_number": "910-662-8440",
            "fax_number": "910-251-8286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 Scotts Hill Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284117983",
            "country_code": "US",
            "telephone_number": "910-662-8440",
            "fax_number": "910-667-6733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MICHAEL",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "2008-00559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "149RU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.