Michael D. Nickell, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

R9A40 Issued in MO

Practice address

2040 W. 32ND St
Joplin, MO 64804

Phone

(417) 627-1300

Fax

(417) 627-1357

NPI assigned

Sep 21, 2005

Last updated

Apr 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Sjmgroup

  • Endocrinology, Diabetes & Metabolism Physician
  • Englewood, CO
  • NPI 1376590034
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1831185206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W. 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-627-1300",
            "fax_number": "417-627-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W. 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-627-1300",
            "fax_number": "417-627-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R9A40",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "R9A40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BNDD",
            "identifier": "20896",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Wade Nichols, D.O.
• Joseph Lawrence Nichols
• Margaret Ellen Nichols, MD
• Matthew Nichols
• Emelie Grace Nickel
• Jaron Richard Nielson, DO
• Bradford Nieman
• Garrett Nikolay, DC
• Maliheh Nikzad, DDS, MSC
• Alleluia Nishimwe

• Hospitalist Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Hospitalist Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.