NPIMap

Individual provider Active NPI

Christopher Mead Nichols, M.D.

  • Plastic Surgery Physician
  • Tacoma, WA
National Provider Identifier
1659477610
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD00049126 Issued in WA
Practice address
6002 Westgate Blvd
Suite 160
Tacoma, WA 98406-2570
Phone
(253) 759-4522
Fax
(253) 759-4699
NPI assigned
Sep 16, 2006
Last updated
Apr 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 2005026727 MO
Plastic Surgery Physician 208200000X MD00049126 WA Primary

Addresses

Primary practice location

6002 Westgate Blvd
Suite 160
Tacoma, WA 98406-2570

Mailing address

6002 Westgate Blvd
Suite 160
Tacoma, WA 98406-2570
Phone (253) 759-4522

Other identifiers 3

IdentifierTypeStateIssuer
0272224OtherWASTATE L&I
G8873979OtherWAMEDICARE
8510752MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080721000103 WA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 2264505692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMN IndustriesGroup PAC ID 0143583807, 3 clinicians

Practice addresses (Care Compare)

145 Lilly Rd NE
Suite 101
Olympia, WA 98506-5028
Phone (360) 878-9300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005026727MOMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMN Industries Plastic Surgery CurrentSince Mar 17, 2018 Accepting new patients
Pearl Plastic Surgery, PLLC Plastic Surgery PastSince Oct 4, 2022 Accepting new patients

Locations

145 Lilly Rd NE
#101
Olympia, WA 98506
Phone (360) 878-9300

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1659477610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 WESTGATE BLVD",
            "address_2": "SUITE 160",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062570",
            "telephone_number": "253-759-4522",
            "fax_number": "253-759-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 WESTGATE BLVD",
            "address_2": "SUITE 160",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062570",
            "telephone_number": "253-759-4522",
            "fax_number": "253-759-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CHRISTOPHER",
        "middle_name": "MEAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "2005026727",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "MD00049126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0272224",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8873979",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8510752",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.