NPIMap

Individual provider Active NPI

Jacob Nichols, MD

  • Infectious Disease Physician
  • Lubbock, TX
National Provider Identifier
1831500578
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
R5299 Issued in TX
Practice address
3601 4TH St
Ms 9410
Lubbock, TX 79430
Phone
(806) 743-6840
NPI assigned
May 15, 2014
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X R5299 TX
Infectious Disease Physician 207RI0200X R5299 TX Primary
Hospitalist Physician 208M00000X R5299 TX

Addresses

Primary practice location

3601 4TH St
Ms 9410
Lubbock, TX 79430

Mailing address

3601 4TH St
Ms 9410
Lubbock, TX 79430-0002
Phone (806) 743-6840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jacob.nichols@direct.myteamcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319001098 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 9234437641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Texas Tech University Health Science Center School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9410
Phone (806) 743-3150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 15, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
City of Lubbock CurrentSince Jul 19, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Internal Medicine CurrentSince Jul 15, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
City of Lubbock Health Department Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Locations

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

2015 50th St
Lubbock, TX 79412
Phone (806) 775-2933

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
Stop 9410
Lubbock, TX 79430
Phone (806) 743-3155

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

806 18th St
Lubbock, TX 79401
Phone (806) 775-2933

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

Hospital & facility affiliations 5

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1831500578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79430",
            "telephone_number": "806-743-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R5299",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "R5299",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "R5299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacob.nichols@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "address_2": "MS 9410",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "79430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.