Terry Lee Nickels, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1706 Issued in OK

Practice address

2803 SE 44TH St
Oklahoma City, OK 73129-8533

Phone

(405) 672-1316

Fax

(405) 670-2477

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1508961095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95165",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731435165",
            "telephone_number": "405-672-1316",
            "fax_number": "405-670-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 SE 44TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731298533",
            "telephone_number": "405-672-1316",
            "fax_number": "405-670-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELS",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nick Knutson MD, a Professional Corporation
• Shannon Deserae Nick
• Sherrie J Nickel, LPN
• Susan Nickelberry
• Szofia Ariana Nickell, DTR
• Evan Hal Nicklas
• Braden James Nickle, DMD
• Sheryl Nicks
• Sydney Lynn Nicol
• Nicole Decamp, MD, PC

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.