Joe Daniel Nichols Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D3947 Issued in TX

Practice address

1011 South William
Atlanta, TX 75551-3245

Phone

(903) 796-2868

Fax

(903) 796-0826

NPI assigned

Aug 16, 2006

Last updated

Aug 28, 2023By the provider in NPPES

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1023630969
  Medicare reassignment NPD
• East Texas Border Health Clinic

  dba Genesis Prime Care

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1558329797

  Family Medicine

  NPD
• East Texas Border Health Clinic

  dba Genesis Primecare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
  • NPI 1598366718

  Family Medicine

  NPD
• Atlanta Hospital Authority

  dba Atlanta Memorial Hospital

  • Rural Acute Care Hospital
  • Atlanta, TX
  • NPI 1073600136
  NPD (past)
• Atlanta Hospital Authority

  dba Atlanta Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Atlanta, TX
  • NPI 1265514798
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1619080561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SOUTH WILLIAM",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755513245",
            "telephone_number": "903-796-2868",
            "fax_number": "903-796-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SOUTH WILLIAM",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755513245",
            "telephone_number": "903-796-2868",
            "fax_number": "903-796-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D3947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123277903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "118076",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "080022253",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97276",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "806052",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Felicia Matthews
• McCall Family Eye Care, LLC
• Miles Drug Company
• Rodney Gene Miller, PHARMACIST
• Teresa Michelle Musgrove, RN
• Northeast Texas Emergency Physicians, PLLC
• Edward Timothy Okelley, MD
• Oliver Family Home Health, Limited Liability Company
• Tiffany Griffin Peace, FNP
• April Dunn Poston, PTA

• Family Medicine Physician in Atlanta, TX
• Providers in Atlanta, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.