Individual provider Active NPI

Carolina Nicholas, M.D.

  • Pediatrics Physician
  • Spring, TX
National Provider Identifier
1871593186
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M1294 Issued in TX
Practice address
8111 Cypresswood Dr
104
Spring, TX 77379-7185
Phone
(281) 376-0707
NPI assigned
Jul 28, 2005
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M1294 TX Primary

Addresses

Primary practice location

8111 Cypresswood Dr
104
Spring, TX 77379-7185

Mailing address

PO Box 841969
Dallas, TX 75284-1969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1294TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cplacencia1235@prddirect.texaschildrens.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1871593186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841969",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 CYPRESSWOOD DR",
            "address_2": "104",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797185",
            "telephone_number": "281-376-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "CAROLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.