Individual provider Active NPI

Dianne Nicholas, M.D.

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1679553499
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J2238 Issued in TX
Practice address
5160 Timber Creek Dr
Houston, TX 77017-5968
Phone
(713) 440-0602
Fax
(713) 944-8903
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X J2238 TX Primary
Internal Medicine Physician 207R00000X J2238 TX

Addresses

Primary practice location

5160 Timber Creek Dr
Houston, TX 77017-5968

Mailing address

PO Box 14231
Houston, TX 77221-4231
Phone (713) 440-0602

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040526001176 TX Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 2860473733 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5160 Timber Creek Dr
Houston, TX 77017-5968
Phone (713) 944-8900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2238TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC CurrentSince Jan 1, 2012 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jul 11, 2017 Accepting new patients
Ess of South Texas LLC Emergency Medicine CurrentSince May 10, 2015 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Feb 19, 2020 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Jan 17, 2019 Accepting new patients
Dianne W. Nicholas M.D., PA Internal Medicine CurrentSince Jun 1, 2010 Accepting new patients
Great Plains Tribal Chairmen'S Health Board CurrentSince Mar 1, 2020 Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2012 Accepting new patients
Ess of Nacogdoches LLC Emergency Medicine CurrentSince Nov 27, 2016 Accepting new patients
Glen Rose Medical Foundation Inc. Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services Emergency Medicine Past Accepting new patients
Glen Rose Medical Foundation Emergency Medicine Past Accepting new patients

Locations

3200 Canyon Lake Dr
Ste 1
Rapid City, SD 57702
Phone (605) 355-2500

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

540 W 15th St
Hereford, TX 79045
Phone (806) 364-2141

6441 Main St
Houston, TX 77030
Phone (713) 790-0500

5160 Timber Creek Dr
Houston, TX 77017
Phone (713) 440-0602

821 Jeffee Dr
Kermit, TX 79745
Phone (432) 586-2040

1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316

200 W Ollie St
Llano, TX 78643
Phone (325) 216-9199

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

1550 First Colony Blvd
Sugar Land, TX 77479
Phone (281) 275-6000

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

400 Youens Dr
Weimar, TX 78962
Phone (409) 725-9531

Interoperability endpoints

  • Direct secure messaging: dianne.nicholas.1@13131.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1679553499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14231",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772214231",
            "telephone_number": "713-440-0602",
            "fax_number": "713-944-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 TIMBER CREEK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770175968",
            "telephone_number": "713-440-0602",
            "fax_number": "713-944-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J2238",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J2238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.