Mark Edward Nichols, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

L0457 Issued in TX

Practice address

605 S Conroe Medical Dr
Conroe, TX 77304-4722

Phone

(936) 539-4004

Fax

(936) 539-3635

NPI assigned

Sep 12, 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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2385/brand/1/csg/1/fhir/r4

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.

• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769

  Obstetrics & Gynecology, TX

  Medicare reassignment NPD
• Westover Hills Women'S Health PA

  • Obstetrics & Gynecology Physician
  • San Antonio, TX
  • NPI 1477765824

  Obstetrics & Gynecology, TX

  Medicare reassignment NPD
• BSZ Medical, P.a.

  • Family Medicine Physician
  • Pleasanton, TX
  • NPI 1285934075

  TX

  Medicare reassignment
• Christus Santa Rosa Health Care Corporation

  • Children's Hospital
  • San Antonio, TX
  • NPI 1821004151
  NPD (past)
• Joan L Bergstrom, MD PA

  • Multi-Specialty Clinic/Center
  • Arlington, TX
  • NPI 1164647434

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891780227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L0457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1560377-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thuy Chau Nguyen, O.D.
• Tien Trieu Nguyen
• Trang Doan Nguyen, MD
• Nhue Ho MD PLLC
• Emily Joy Nicholls, M.S., CCC-SLP
• Vicky Nichols, LVN
• Katrina Renee Nico, APRN, PMHNP-BC
• Emily Ann Niebel, M.S., CCC-SLP
• Danielle Lee Nielsen, NP-C
• Kassandra Kamma Nielsen, RNFA, CNOR, BSN

• All providers in Conroe, TX
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.