Active NPI
Richard D Nichols, M.D.
- Specialist
- Lakeland, FL
National Provider Identifier
1659365161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME88932
- Practice address
- 515 E Garden St
Lakeland, FL 33805-4615 - Phone
- (863) 683-5454
- Fax
- (863) 683-4652
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME88932 | FL | Primary |
Addresses
Primary practice location
515 E Garden St
Lakeland, FL 33805-4615
Mailing address
PO Box 1725
Lakeland, FL 33802-1725
Phone (863) 683-5454
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37724 | Other | FL | BCBS |
| 292845 | Other | AVMED | |
| 4036259 | Other | AETNA | |
| 210792 | Other | AMERIGROUP | |
| 239523 | Other | WELLCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida ENT Associates, LLC | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Lakeland, FL
- NPI 1992812531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1659365161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1725",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338021725",
"telephone_number": "863-683-5454",
"fax_number": "863-683-4652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 E GARDEN ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338054615",
"telephone_number": "863-683-5454",
"fax_number": "863-683-4652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "RICHARD",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME88932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "37724",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "292845",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4036259",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "210792",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "239523",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.