Scott R. Nichols M.D. P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C6461 Issued in AR

Legal business name

SCOTT R. NICHOLS M.D. P.A.

Practice address

3801 Camden Rd # 22
Pine Bluff, AR 71603-4612

Phone

(870) 879-3517

NPI assigned

Aug 18, 2009

Organization subpart

No

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

Authorized official

Name

Scott R Nichols, MDNPI 1275577280

Title

Owner

Phone

(870) 879-3517

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Richard Nichols, M.D.

  • Family Medicine Physician
  • Pine Bluff, AR
  • NPI 1275577280
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1861624330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD # 22",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-879-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 CAMDEN RD # 22",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034612",
            "telephone_number": "870-879-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT R. NICHOLS M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-879-3517",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Scarver
• Nickolas David Scherzer, MD
• Ashton Delaine Scoggins, DPT
• Catherine Scoggins, L.P.T.A.
• Scott K Gray, DPM
• Kassandra Rose Scott, NP
• Shalisa Donnay Scott
• Shuntar Lasel Scott
• SCPG Arkansas LLC
• SCPG Arkansas LLC

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.