Kim Myruth Nichols, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

051631 Issued in CT

Practice address

469 W Putnam Ave
Suite 201
Greenwich, CT 06830-6895

Phone

(203) 862-4000

Fax

(203) 862-4008

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nicholsmdofgreenwich.kimnichols@146514.advancedmd-direct.com

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.

• Austin FP

  • Ambulatory Surgical Clinic/Center
  • Garden City, NY
  • NPI 1932353265
  NPD (past)
• Garden City Dermatology, PC

  • Dermatopathology Physician
  • Garden City, NY
  • NPI 1881653194
  NPD (past)
• Skin Specialty Dermatology - Fran E. Cook-Bolden M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1225360399
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1679513212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 W PUTNAM AVE",
            "address_2": "SUITE 201",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306895",
            "telephone_number": "203-862-4000",
            "fax_number": "203-862-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 W PUTNAM AVE",
            "address_2": "SUITE 201",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306895",
            "telephone_number": "203-862-4000",
            "fax_number": "203-862-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KIM",
        "middle_name": "MYRUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "051631",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "239556",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "051631",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Newman
• Sharon Ann Newport, MD
• Newyork Nightingale Corporation
• Next Step Up Corp
• Barbara Cynthia NG, MD
• Kathryn A Niebuhr, LMFT LADC
• Nicole Clemente Noble, M.A., CCC-SLP
• David P Nocek, M.D.
• North Street Pharmacy
• Northeast Medical Group Inc

• Dermatology Physician in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.