Individual provider Active NPI

Daniel James Nichols, MS, MSM, PA-C

  • Physician Assistant
  • Cedar Rapids, IA
National Provider Identifier
1780839605
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
074769 Issued in IA
Practice address
202 10TH St SE
Cedar Rapids, IA 52403-2414
Phone
(319) 247-3010
Fax
(877) 303-8768
NPI assigned
Nov 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0000000865 TN
Physician Assistant 363A00000X 085005376 IL
Medical Physician Assistant 363AM0700X 2401 TN
Physician Assistant 363A00000X 074769 IA Primary

Addresses

Primary practice location

202 10TH St SE
Cedar Rapids, IA 52403-2414

Mailing address

202 10TH St SE Ste 140
Cedar Rapids, IA 52403-2432
Phone (319) 398-1545

Other names 1

  • Mr. Dan Nichols Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150220000376 IL Practitioner - Physician Assistant 7517185341 Reassigns benefits to 1 organization
I20150220001804 IA Practitioner - Physician Assistant 7517185341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic of Iowa PCGroup PAC ID 2163325242, 132 clinicians

Practice addresses (Care Compare)

202 10TH St SE
Cedar Rapids, IA 52403-2414
Phone (319) 247-3010

275 10TH St SE
Cedar Rapids, IA 52403-2414
Phone (319) 247-3010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0000000865TNMDAthletic Trainer
2401TNMDAthletic Trainer
085005376ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Physicians Clinic of Iowa, PC CurrentSince Mar 21, 2025 Accepting new patients
Medical Observation Services LLC Past Accepting new patients
Ora Orthopedics, PC Past Accepting new patients
Volunteer Medical Group, P.C. Past Accepting new patients

Locations

202 10th St SE
Cedar Rapids, IA 52403
Phone (319) 247-3010

202 10th St SE
Ste 140
Cedar Rapids, IA 52403
Phone (319) 398-1506

202 10th St SE
Ste 165
Cedar Rapids, IA 52403
Phone (319) 247-3049

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIJCBD
  • Direct secure messaging: dnichols238526@direct.unitypoint.org
  • Direct secure messaging: daniel.nichols@pciowa.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1780839605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 10TH ST SE STE 140",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032432",
            "telephone_number": "319-398-1545",
            "fax_number": "309-762-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032414",
            "telephone_number": "319-247-3010",
            "fax_number": "877-303-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MS, MSM, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-19",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "0000000865",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005376",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2401",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "074769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAN",
            "last_name": "NICHOLS",
            "prefix": "MR.",
            "credential": "MS, MSM, PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.