Individual provider Active NPI

Kitra Nichols, FNP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1467893891
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18366 Issued in SC
Practice address
166 Stoneridge Dr
Columbia, SC 29210-8239
Phone
(803) 461-3000
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18366 SC Primary

Addresses

Primary practice location

166 Stoneridge Dr
Columbia, SC 29210-8239

Mailing address

166 Stoneridge Dr
Columbia, SC 29210-8239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013001452 SC Practitioner - Nurse Practitioner 0840410999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18366SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Oncology Assoc PA CurrentSince Aug 1, 2014 Accepting new patients

Locations

166 Stoneridge Dr
Columbia, SC 29210
Phone (803) 296-5954

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1467893891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 STONERIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 STONERIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108239",
            "telephone_number": "803-461-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KITRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.