Justin Ryan Nickel

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1134807 Issued in TX

Practice address

5208 Tennyson Pkwy Ste 100
Plano, TX 75024-7183

Phone

(844) 464-1611

NPI assigned

Sep 4, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Communitymed PLLCGroup PAC ID 9830315126, 46 clinicians

Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Communitymed PLLC

  • Urgent Care Clinic/Center
  • Melissa, TX
  • NPI 1821417072
  Medicare reassignment Care Compare group NPD
• Doctors Express of the Beaumont Area PA

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1841525235
  Medicare reassignment Care Compare group NPD
• Communitymed PCP

  • Primary Care Clinic/Center
  • Melissa, TX
  • NPI 1063818219
  Medicare reassignment NPD
• Doctors Express of the Temple Area, PA

  • Urgent Care Clinic/Center
  • Temple, TX
  • NPI 1568696227
  NPD (past)

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1750167086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 DAFFODIL ST",
            "city": "PRINCETON",
            "state": "TX",
            "postal_code": "754079794",
            "telephone_number": "214-726-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 TENNYSON PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247183",
            "telephone_number": "844-464-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "JUSTIN",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1134807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Elizabeth Nicholson-Guidry, FNP
• Sandra Nicholson-Harned
• William D Nicholson IV, MD
• William Henry Nicholson, DDS
• Nick Nicholson, M.D., P.a.
• Everica Amarilda Nicolas Sebastian
• Nicole Reed Medical, PLLC
• Nidi Enterprise, LLC
• Sherry C Niederkorn, M.S.,CCC-A
• Heli Maarit Niemi, M.D.

• Family Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.

Verify at the official NPI Registry.