Holly N Nichols, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP7482 Issued in AZ

Practice address

4045 E Bell Rd Ste 125
Phoenix, AZ 85032-2238

Phone

(602) 971-0268

Fax

(602) 971-1556

NPI assigned

Feb 27, 2006

Last updated

Feb 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Dermatology and Mohs Center PCGroup PAC ID 7113144510, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Dermatology & Mohs Center, PC

  • Specialist
  • Phoenix, AZ
  • NPI 1861813156
  Medicare reassignment Care Compare group NPD
• Mark a Meyers

  dba New Leaf Dermatology

  • Specialist
  • Payson, AZ
  • NPI 1790246924
  NPD (past)
• Central Plains Cardiothoracic Surgery, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wichita, KS
  • NPI 1124215900
  NPD (past)
• Kansas Surgical Consultants, LLP

  • Surgery Physician
  • Wichita, KS
  • NPI 1215903976
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1780650036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322238",
            "telephone_number": "602-971-0268",
            "fax_number": "602-971-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322238",
            "telephone_number": "602-971-0268",
            "fax_number": "602-971-1556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 S Beeline Hwy",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855415320",
            "country_code": "US",
            "telephone_number": "928-468-6607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 S Beeline Hwy",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855414814",
            "country_code": "US",
            "telephone_number": "928-472-7107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "HOLLY",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22657",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45627",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP7482",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "45627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200266080A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011884",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Lee Nicholas, MD
• Johnathan Tyler Nicholls, CRNA
• Brenda Nichols
• Brienna Nichols, CRNA
• Dawn Nicole Nichols, RN
• James Robert Nichols, MD
• Jodie Beth Nichols, DO
• Joe Lynn Nichols, MD
• Karen Ruth Nichols, PA-C
• Kristine B Nichols

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.