Active NPI
Richard Earl Nicholson, MD
- Family Medicine Physician
- Bishop, CA
National Provider Identifier
1760536478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G070442
- Practice address
- 52 N Tu Su LN
Bishop, CA 93514-8058 - Phone
- (760) 873-8461
- Fax
- (760) 873-3530
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G070442 | CA | Primary |
Addresses
Primary practice location
52 N Tu Su LN
Bishop, CA 93514-8058
Mailing address
3475 W Line St
Bishop, CA 93514-2155
Phone (760) 937-7579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050701000792 | CA | Practitioner - Family Practice | 6800832544 | Practice locations: Bishop, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of South Alabama College of Medicine, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
151 Pioneer LN
Bishop, CA 93514-2557
Phone (760) 872-1000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70442 | CA | MD | Pharmacist |
| G070442 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1760536478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3475 W LINE ST",
"city": "BISHOP",
"state": "CA",
"postal_code": "935142155",
"telephone_number": "760-937-7579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 N TU SU LN",
"city": "BISHOP",
"state": "CA",
"postal_code": "935148058",
"telephone_number": "760-873-8461",
"fax_number": "760-873-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "RICHARD",
"middle_name": "EARL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G070442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bishop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.
- 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.