Karen Ruth Nichols, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1009350 Issued in AZ

Practice address

2632 N 20TH St
Phoenix, AZ 85006-1339

Phone

(602) 266-2200

Fax

(602) 240-6177

NPI assigned

Nov 16, 2006

Last updated

Nov 1, 2007By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1841363819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61773",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850821773",
            "telephone_number": "602-682-6701",
            "fax_number": "602-240-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 N 20TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061339",
            "telephone_number": "602-266-2200",
            "fax_number": "602-240-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KAREN",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1009350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740151",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUN HEALTH GROUP #",
            "identifier": "WCSKQ",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Nicole Nichols, RN
• Holly N Nichols, NP
• James Robert Nichols, MD
• Jodie Beth Nichols, DO
• Joe Lynn Nichols, MD
• Kristine B Nichols
• Shawn Leah Nichols, DDS
• Taylor Nichols, PHARMD
• Travis Nichols, PH.D.
• Alexandra Helene Nicholson, M.D.

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.