Randall Wayne Nichols, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9258 Issued in AL

Practice address

2431 W Main St
Suite 1001
Dothan, AL 36301-1217

Phone

(334) 677-6220

Fax

(334) 677-2206

NPI assigned

Oct 10, 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

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

Merit-based Incentive Payment System (MIPS)

Final score

23.46 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

78.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: rnichols27731@southeasthealth.direct-ci.com

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.

• Randall W. Nichols M D , PC

  • Surgery Physician
  • Dothan, AL
  • NPI 1164665188
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1518055334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6188",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363026188",
            "telephone_number": "334-677-6220",
            "fax_number": "334-677-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "SUITE 1001",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-677-6220",
            "fax_number": "334-677-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "RANDALL",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "9258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069046500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529906170",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00296557C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51083586",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcey Nicholas, CRNP
• Christopher E Nicholls, MD
• Eugene W Nicholls, O.D.
• Melanie P. Nicholls, MD
• Kimberly K Nichols, CRNP PHD
• Nicole N Thorson, LLC
• Venkat R Nimmagadda, M.D.
• Hannah Harris Nix
• Angie G. Nixon, MA, ALC
• No Needles Children'S Dentistry

• Surgery Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.