Mark Lovel Nichols, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

24472 Issued in NC

Practice address

250 Hospice Cir
Raleigh, NC 27607-6372

Phone

(919) 828-0890

Fax

(919) 719-0395

NPI assigned

Sep 26, 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

Practice roles

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.

• Rex Hospital, Inc.

  dba Rex Nutrition Services

  • Nutrition Education Nutritionist
  • Raleigh, NC
  • NPI 1821472572
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
  • NPI 1013203819
  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians

  • Surgery Physician
  • Raleigh, NC
  • NPI 1396791786

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1902892946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 COLEY FOREST PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124740",
            "telephone_number": "919-855-8911",
            "fax_number": "919-855-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPICE CIR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076372",
            "telephone_number": "919-828-0890",
            "fax_number": "919-719-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARK",
        "middle_name": "LOVEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "24472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8962543",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Kennedy Nichols, MD
• Brian Nichols, LAT, ATC
• Chyanne Nichols
• Grayson G Nichols, LCSW
• Marilouise Elizabeth Nichols, M.S., CCC-SLP, BCS-S
• Charles Hathaway Nicholson, MD
• Jasmin Nicholson
• Laura Lee Nicholson, OTR L
• Lucille Nicholson
• Nora C Nicholson

• Internal Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.