Chong H Nicholls, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01073755A Issued in IN

Practice address

8075 N Shadeland Ave Ste 200
Indianapolis, IN 46250-2694

Phone

(317) 621-8500

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, VA, MT3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cnicholls214659@direct.metrohealth.org
• Direct secure messaging: cnicholls201137@direct.rivhs.com

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.

• American Anesthesiology of Virginia PC

  • Anesthesiology Physician
  • Falls Church, VA
  • NPI 1417994872
  Medicare reassignment NPD
• Anesthesia Services of San Joaquin, P.C.

  • Anesthesiology Physician
  • French Camp, CA
  • NPI 1366778227
  Medicare reassignment NPD
• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845
  Medicare reassignment NPD
• Cep America - Anesthesia, PC

  • Anesthesiology Physician
  • Walnut Creek, CA
  • NPI 1790401438
  Medicare reassignment NPD
• Oak Creek Anesthesia Services, Inc.

  • Anesthesiology Physician
  • Visalia, CA
  • NPI 1619589512
  Medicare reassignment NPD
• Central California Anesthesia & Pain Management Associates

  • Anesthesiology Physician
  • Turlock, CA
  • NPI 1437234390
  NPD (past) Authorized official
• Deaconess Hospital, Inc

  dba Deaconess Care Group

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  NPD
• American Anesthesiology of Virginia, PC

  • Anesthesiology Physician
  • Leesburg, VA
  • NPI 1053675199
  NPD
• Billings Clinic

  dba Billings Clinic Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Billings, MT
  • NPI 1003953589
  NPD
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714
  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Langhorne, PA
  • NPI 1093678229
  NPD
• Cep America - Anesthesia PC

  dba Vituity

  • Anesthesiology Physician
  • Lodi, CA
  • NPI 1821457300
  NPD

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1902850068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2336",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726542336",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 N SHADELAND AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502694",
            "telephone_number": "317-621-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Ralston Ave",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435121396",
            "country_code": "US",
            "telephone_number": "419-783-6944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "624 Hospital Drive",
            "address_purpose": "LOCATION",
            "city": "Mountain Home",
            "state": "AR",
            "postal_code": "726532955",
            "country_code": "US",
            "telephone_number": "870-508-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "CHONG",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "37081",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35.129284",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A80622",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01073755A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01370816",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188700001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201216590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryn Katherine Nicholas, BCABA
• Karen Nicholas
• Keonna Nicholas, RBT
• Michael L Nicholas, M.D.
• Natalie A Nicholas, SPEECH LANGUAGE PATH
• Nathanael Charles Nicholls
• Alison Nichols
• Amy Susan Nichols, M.S.
• Ayesha Nichols, M.D.
• Cydney Morgan Nichols

• Anesthesiology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.