Individual provider Active NPI

Nicole Marie White Malin, MD, MA

  • Emergency Medicine Physician
  • Oxford, OH
National Provider Identifier
1588996524
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35126430 Issued in OH
Practice address
110 N Poplar St
Oxford, OH 45056-1204
Phone
(513) 523-2111
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125055936 IL
Emergency Medicine Physician 207P00000X 35126430 OH Primary

Addresses

Primary practice location

110 N Poplar St
Oxford, OH 45056-1204

Mailing address

65 Hunter Woods Dr
Oxford, OH 45056-9040
Phone (206) 234-3871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20151006000907 OH Practitioner - Emergency Medicine 8022253707 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125055936ILMDEmergency Medicine Physician
35126430OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Talawanda Emergency Physicians, Inc. Emergency Medicine CurrentSince Aug 29, 2015 Accepting new patients
Qualified Emergency Specialists Inc Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

75 Remittance Dr
Dept 6508
Chicago, IL 60675

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

110 N Poplar St
Oxford, OH 45056
Phone (513) 523-2111

Organizations & group practices 2

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1588996524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HUNTER WOODS DR",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450569040",
            "telephone_number": "206-234-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N POPLAR ST",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450561204",
            "telephone_number": "513-523-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE MALIN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "MD, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125055936",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35126430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, OH

Sources for this page

Verify at the official NPI Registry.