Robert R Nichols, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0417312 Issued in KS

Practice address

403 Woodland Hills Blvd
Fort Scott, KS 66701-8798

Phone

(620) 223-8040

Fax

(620) 223-8524

NPI assigned

Nov 11, 2005

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1891776209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 WOODLAND HILLS BLVD",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667018798",
            "telephone_number": "620-223-8040",
            "fax_number": "620-223-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 WOODLAND HILLS BLVD",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667018798",
            "telephone_number": "620-223-8040",
            "fax_number": "620-223-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0417312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100165410B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fort Scott, KS
• Providers in Fort Scott, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.