Individual provider Active NPI

Garvin Nickell, MD

  • Internal Medicine Physician
  • Mason, OH
National Provider Identifier
1861456568
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35070234N Issued in OH
Practice address
9313 S Mason Montgomery Rd
Ste. 200
Mason, OH 45040-8008
Phone
(513) 584-6999
Fax
(513) 584-6998
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35070234N OH Primary

Addresses

Primary practice location

9313 S Mason Montgomery Rd
Ste. 200
Mason, OH 45040-8008

Mailing address

PO Box 636256 Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5501

Other identifiers 1

IdentifierTypeStateIssuer
2020986MedicaidOH

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
I20041119000001 OH Practitioner - Internal Medicine 6507820438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wright State University Boonshoft School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

9313 S Mason Montgomery Rd
Suite 200
Mason, OH 45040-8046
Phone (513) 584-6999

Hospital & facility affiliations

  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • West Chester Hospital Hospital, West Chester, OH, CCN 360354
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • The Jewish Hospital-Mercy Health Hospital, Cincinnati, OH, CCN 360016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35070234NOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Internal Medicine CurrentSince Jul 1, 2002 Accepting new patients

Locations

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

9313 S Mason Montgomery Rd
Ste 200
Mason, OH 45040
Phone (513) 584-6737

9311 S Mason Montgomery Rd
Mason, OH 45040
Phone (513) 584-6999

Interoperability endpoints

  • Direct secure messaging: gnickell13071@direct.uchealth.com

Organizations & group practices 1

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 6

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1861456568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256 CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5501",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9313 S MASON MONTGOMERY RD",
            "address_2": "STE. 200",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408008",
            "telephone_number": "513-584-6999",
            "fax_number": "513-584-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "GARVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35070234N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.