Kelsey Nichols, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1033753 Issued in TX

Practice address

4545 Bellaire Dr S Ste 9
Fort Worth, TX 76109-1811

Phone

(817) 763-8300

NPI assigned

May 23, 2021

Sex

Female

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark Lindemann DO PAGroup PAC ID 0840516662, 4 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.

• Mark Lindemann DO PA

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1487835914
  Medicare reassignment Care Compare group NPD
• Ethos Regenerative Medical Group PLLC

  • Chiropractor
  • Irving, TX
  • NPI 1306016282
  NPD (past)

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

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1760057723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 9",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 9",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-763-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KELSEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-23",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1033753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Wayne Nichols Jr., PT
• Cheryl A Nichols, L.P.C.
• Crystall Alisha Nichols, RBT-26-506912
• Jennifer Nichols, CCC-SLP
• Karen Nichols, RN
• Lien T Nichols, PA
• Sarah Joy Nichols, LCSW
• Craig Anthony Nicholson, RPH
• Monique Brown Nicholson, R.PH
• Paulina Nicholson, LPC

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, 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 Aug 29, 2022; 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.