Active NPI
Robert L Nichols, MD
- General Practice Physician
- Santa Teresa, NM
National Provider Identifier
1679634562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 94-344
- Practice address
- 1300 Country Club Road
Santa Teresa, NM 88008 - Phone
- (505) 589-4000
- Fax
- (505) 589-7225
- NPI assigned
- Dec 13, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 94-344 | NM | |
| General Practice Physician | 208D00000X | 94-344 | NM | Primary |
Addresses
Primary practice location
1300 Country Club Road
Santa Teresa, NM 88008
Mailing address
PO Box 1558
Santa Teresa, NM 88008
Phone (505) 589-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041117001251 | NM | Practitioner - Family Practice | 6901860071 | Practice locations: Santa Teresa, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of New Mexico School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1300 Country Club Rd
Suite D
Santa Teresa, NM 88008-9449
1300 Country Club Rd D
Santa Teresa, NM 88008-9449
Phone (505) 589-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-344 | NM | MD | General Practice Physician |
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Las Cruces, NM
- NPI 1841436144
-
- General Acute Care Hospital
- El Paso, TX
- NPI 1215969787
-
- General Acute Care Hospital
- El Paso, TX
- NPI 1538522412
-
- Rehabilitation Hospital Unit
- El Paso, TX
- NPI 1780927277
-
- Home Health Agency
- El Paso, TX
- NPI 1295831527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1679634562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1558",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "88008",
"telephone_number": "505-589-4000",
"fax_number": "505-589-7225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 COUNTRY CLUB ROAD",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "88008",
"telephone_number": "505-589-4000",
"fax_number": "505-589-7225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "ROBERT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "94-344",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NM",
"license": "94-344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Teresa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.