Individual provider Active NPI

Sydney Nichols, FNP-C

  • Family Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1740754076
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139088 Issued in TX
Practice address
301 Highlander Blvd Ste 121
Arlington, TX 76018-1164
Phone
(817) 468-7200
Fax
(817) 468-7201
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 878961 TX
Family Nurse Practitioner 363LF0000X AP139088 TX Primary

Addresses

Primary practice location

301 Highlander Blvd Ste 121
Arlington, TX 76018-1164

Mailing address

301 Highlander Blvd Ste 121
Arlington, TX 76018-1164
Phone (817) 468-7200

Other practice location 1

200 Pecan Crk Ste 200
Southlake, TX 76092-6373
Phone (817) 468-7200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190308002025 TX Practitioner - Nurse Practitioner 7618216672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Practice Associates, PLLCGroup PAC ID 0143367342, 6 clinicians

Practice addresses (Care Compare)

200 Pecan CRK
Southlake, TX 76092-6371
Phone (817) 468-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
878961TXMDRegistered Nurse
AP139088TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Practice Associates, PLLC CurrentSince Feb 1, 2019 Accepting new patients

Locations

301 Highlander Blvd
Ste 121
Arlington, TX 76018
Phone (817) 332-7600

200 Pecan Crk
Southlake, TX 76092
Phone (817) 468-7200

200 Pecan Crk
Ste 200
Southlake, TX 76092
Phone (817) 442-8554

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFAHAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1740754076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HIGHLANDER BLVD STE 121",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181164",
            "telephone_number": "817-468-7200",
            "fax_number": "817-468-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHLANDER BLVD STE 121",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760181164",
            "telephone_number": "817-468-7200",
            "fax_number": "817-468-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Pecan Crk Ste 200",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926373",
            "country_code": "US",
            "telephone_number": "817-468-7200",
            "fax_number": "817-468-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SYDNEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "878961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.