Tina Marie Nichols, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

244202 Issued in NY

Practice address

3344 Chambers Rd Ste 200
Horseheads, NY 14845-1403

Phone

(607) 734-2264

Fax

(607) 734-2932

NPI assigned

Jun 29, 2007

Last updated

Mar 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Guthrie Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Corning, NY
  • NPI 1134178635
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD
• Guthrie Medical Group PC

  • Clinical Medical Laboratory
  • Sayre, PA
  • NPI 1649225855
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1669679916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 CHAMBERS RD STE 200",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148451403",
            "telephone_number": "607-734-2264",
            "fax_number": "607-734-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Hoffman St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149052263",
            "country_code": "US",
            "telephone_number": "607-734-2264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "254 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148302925",
            "country_code": "US",
            "telephone_number": "607-937-5317",
            "fax_number": "607-937-6254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "244202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnichols136838@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3344 Chambers Rd Ste 200",
            "city": "Horseheads",
            "state": "NY",
            "country_code": "US",
            "postal_code": "148451403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• National Vision Inc (America's Best Contacts & Eyeglasses)
• National Vision, Inc.
• Neighborhood Family Medicine, PLLC
• New Therapy
• Ann H. Newman, NURSE PRACTITIONER
• Jenna Nickerson, NP
• Michal J Niedzielski, P.T.
• Heidie Elizabeth Nobles, PA
• Nurtured Beginnings LCSW Therapy, PLLC
• Ameigh O'Connell

• Pediatrics Physician in Horseheads, NY
• Providers in Horseheads, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.