Individual provider Active NPI

Nickolas Lloyd Lind, M.D.

  • Family Medicine Physician
  • Blythe, CA
National Provider Identifier
1689864340
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A35559 Issued in CA
Practice address
322 W Hobsonway
Blythe, CA 92225-1652
Phone
(909) 382-7100
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A35559 CA Primary

Addresses

Primary practice location

322 W Hobsonway
Blythe, CA 92225-1652

Mailing address

322 W Hobsonway
Blythe, CA 92225-1652
Phone (909) 382-7100

Other identifiers 1

IdentifierTypeStateIssuer
N/AOtherN/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200114001059 CA Practitioner - Family PracticePractitioner - General Practice 5890120257 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A35559CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2022 Accepting new patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Central City Community Health Center Inc CurrentSince Nov 12, 2019 Accepting new patients
Central City Community Health Center Inc General Practice Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Central City Community Health Center Inc CurrentSince Nov 12, 2019 Accepting new patients
Sac Health System CurrentSince Jun 1, 2022 Accepting new patients
Sac Health System CurrentSince Jun 1, 2022 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

322 W Hobsonway
Blythe, CA 92225
Phone (619) 922-9101

332 W Hobsonway
Blythe, CA 92225
Phone (760) 477-0733

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1860 Hamner Ave
Norco, CA 92860
Phone (951) 479-0070

1000 San Gabriel Blvd
Ste 200
Rosemead, CA 91770
Phone (323) 724-0019

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: nlind542258@direct.llu.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689864340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W HOBSONWAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251652",
            "telephone_number": "909-382-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W HOBSONWAY",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251652",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIND",
        "first_name": "NICKOLAS",
        "middle_name": "LLOYD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A35559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "N/A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blythe, CA

Sources for this page

Verify at the official NPI Registry.