Individual provider Active NPI

Gina Marie Nichols, MD

  • Family Medicine Physician
  • Pickerington, OH
National Provider Identifier
1821026451
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.086704 Issued in OH
Practice address
38 E Columbus St
Pickerington, OH 43147-2316
Phone
(614) 834-7030
Fax
(614) 834-7031
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.086704 OH Primary

Addresses

Primary practice location

38 E Columbus St
Pickerington, OH 43147-2316

Mailing address

38 E Columbus St
Pickerington, OH 43147-2316
Phone (614) 834-7030

Other identifiers 3

IdentifierTypeStateIssuer
0114511OtherOHUNITED HEALTHCARE OF OHIO
2611267MedicaidOH
000000377623OtherOHANTHEM BC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000740 OH Practitioner - Family Practice 6709810740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1755 Lancaster Ave
Reynoldsburg, OH 43068-3108
Phone (614) 834-7030

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MD Connect Solutions LLC Current Accepting new patients
Central Ohio Medical Management LLC Family Medicine CurrentSince Nov 15, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Dublin Urgent Care Inc Past Accepting new patients

Organizations & group practices 4

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 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1821026451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 E COLUMBUS ST",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431472316",
            "telephone_number": "614-834-7030",
            "fax_number": "614-834-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 E COLUMBUS ST",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431472316",
            "telephone_number": "614-834-7030",
            "fax_number": "614-834-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.086704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF OHIO",
            "identifier": "0114511",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2611267",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000377623",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

Verify at the official NPI Registry.