Ted M. Nicklaus

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

D2283 Issued in TX

Legal business name

TED M. NICKLAUS

Practice address

101 Wallace Blvd
Amarillo, TX 79106

Phone

(806) 355-7453

NPI assigned

Oct 22, 2007

Last updated

Nov 3, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Constance Sue Klagge

Title

Medical Records Admin

Phone

(806) 463-5111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194048000000",
    "number": "1699964098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7066",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791147066",
            "telephone_number": "806-463-5111",
            "fax_number": "806-463-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79106",
            "telephone_number": "806-355-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED M. NICKLAUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-11-03",
        "status": "A",
        "authorized_official_last_name": "KLAGGE",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "MEDICAL RECORDS ADMIN",
        "authorized_official_telephone_number": "806-463-5111",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "D2283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Bess Taylor, PMHNP
• Victor Marcus Taylor, M.D.
• TC Amarillo 1 LLC (Texas Care Amarillo)
• Jada L Teafatiller
• April Tebeest, RN
• Charles Sloan Teeple, MD
• Jon Tegtmeier
• Ryan Dane Teichelman, PA-C
• Sarah E Teichelman, NP
• Shayne R Teichelman, NP

• Skilled Nursing Facility in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2007; 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.