David R Nichols, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

C5475 Issued in AR

Practice address

1835 Grant Ave
Nea Clinic
Jonesboro, AR 72403-1960

Phone

(870) 934-5117

Fax

(870) 932-3608

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fort Smith Regional Dialysis Center, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Van Buren, AR
  • NPI 1760092597
  NPD (past)
• Northeast Arkansas Clinic, PA

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1376517177
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1528055449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2420",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729022420",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 GRANT AVE",
            "address_2": "NEA CLINIC",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-934-5117",
            "fax_number": "870-932-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "C5475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Taylor Newton, LCSW
• Raphael N Ngengwe, MD
• Henry M Nguyen
• Linda Nguyen, P.A.
• Amanda Elizabeth Nichols, BS PHARMACY
• Maranda Elizabeth Nichols, PA-C, MPH
• Meagan Nichols
• Melissa Suzanne Nichols
• Sara Jane Nichols, BSE/MSE
• Virginia Nicholson

• Pulmonary Disease Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Pulmonary Disease Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.