Renetta Ruth Nichols, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

005058 Issued in AR

Practice address

2158 Butterfield Coach Rd Ste 100
Springdale, AR 72764-9142

Phone

(479) 757-5026

Fax

(479) 757-5028

NPI assigned

Feb 26, 2017

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Female

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 AR

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ozark Physical Therapy Inc.Group PAC ID 1052400850, 44 clinicians

Northwest Physicians LLCGroup PAC ID 0244213213, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

Merit-based Incentive Payment System (MIPS)

Final score

87.5 of 100Reported as apm

Quality

69.34

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: renetta.nichols.4@2229.direct.athenahealth.com

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.

• Northwest Physicians LLC

  • Obstetrics Physician
  • Springdale, AR
  • NPI 1194768721
  Medicare reassignment Care Compare group NPD
• Northwest Benton County Physician Services LLC

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1871553073
  Medicare reassignment NPD
• Ozark Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Berryville, AR
  • NPI 1700843612
  Care Compare group
• Northwest Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Springdale, AR
  • NPI 1205137536
  NPD

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

• Northwest Arkansas Hospitals, LLC

  dba Northwest Medical Center

  • General Acute Care Hospital
  • Springdale, AR
  • NPI 1699726695
  Care Compare affiliation

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1487194346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 BUTTERFIELD COACH RD STE 100",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727649142",
            "telephone_number": "479-757-5026",
            "fax_number": "479-757-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 BUTTERFIELD COACH RD STE 100",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727649142",
            "telephone_number": "479-757-5026",
            "fax_number": "479-757-5028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Sun Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Centerton",
            "state": "AR",
            "postal_code": "727199610",
            "country_code": "US",
            "telephone_number": "479-795-0426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "RENETTA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-26",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "005058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "renetta.nichols.4@2229.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR DIRECT ADDRESS",
            "address_1": "2158 Butterfield Coach Rd Ste 100",
            "city": "Springdale",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727649142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Nguyen, CRNA
• John Daniel Nicholas, PA-C
• Corey C Nichols, DDS
• Kayla Nichols
• Paul D Nichols
• Rick D. Nichols, D.D.S
• Sherry Diane Nichols, LPN
• Matthew Nickle, P.T.
• Carrie A Nickles, LPC
• Kyra Drewery Nielsen, COTA/L

• Family Nurse Practitioner in Springdale, AR
• Providers in Springdale, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.