Courtney G Nichols, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36-00-3269-N Issued in OH

Practice address

27378 W Oviatt Rd
Bay Village, OH 44140-2139

Phone

(440) 871-4700

Fax

(440) 871-4702

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dpmgiaimoproh LLC

  • Primary Podiatric Medicine Podiatrist
  • New Boston, OH
  • NPI 1912945965
  NPD (past)
• Dpmwoleryproh LLC

  • Primary Podiatric Medicine Podiatrist
  • Portsmouth, OH
  • NPI 1215983770
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1699713552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 S MASON MONTGOMERY RD",
            "address_2": "SUITE C",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450401764",
            "telephone_number": "513-229-0101",
            "fax_number": "513-860-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27378 W OVIATT RD",
            "city": "BAY VILLAGE",
            "state": "OH",
            "postal_code": "441402139",
            "telephone_number": "440-871-4700",
            "fax_number": "440-871-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "COURTNEY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-3269-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2294324",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Milling, LISW
• P.B. Mondalek, REGISTER NURSE
• Brian Samuel Morningstar, DDS
• Cara Murthy, DMD
• Pamela Sue Neumann, LSW
• Jacquelynn Taylor O'Connor, RBT
• Ohio CVS Stores LLC
• Omnia Function LLC
• Optical Showcase, Inc.
• Oviatt 26611

• Podiatrist in Bay Village, OH
• Providers in Bay Village, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.