Individual provider Active NPI

Lee Nichols Jr., M.D.

  • Orthopaedic Surgery Physician
  • Florence, AL
National Provider Identifier
1922152503
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
16182 Issued in AL
Practice address
426 W College St
Florence, AL 35630-5521
Phone
(256) 718-4041
Fax
(256) 718-3665
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 16182 AL Primary

Addresses

Primary practice location

426 W College St
Florence, AL 35630-5521

Mailing address

426 W College St
Florence, AL 35630-5521
Phone (256) 718-4041

Other identifiers 5

IdentifierTypeStateIssuer
753040383OtherALTAX ID
51515546OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
181487MedicaidAL
0009996510MedicaidAL
51507189OtherALBLUE CROSS BLUE SHIELD OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20100824000033 AL Practitioner - Orthopedic Surgery 6305876608 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ecm Health Group LLC CurrentSince Jan 1, 2016 Accepting new patients
Shoals Orthopedics, PC Orthopaedic Surgery CurrentSince May 1, 2002 Accepting new patients

Locations

2129 Helton Dr
Ste A
Florence, AL 35630
Phone (256) 718-3200

1751 Veterans Dr
Ste 300
Florence, AL 35630
Phone (256) 718-3200

2129 Helton Dr
Florence, AL 35630
Phone (256) 718-3200

541 W College St
Ste 3300
Florence, AL 35630
Phone (256) 766-6026

541 W College St
Ste 3200
Florence, AL 35630
Phone (256) 760-0098

426 W College St
Florence, AL 35630
Phone (256) 718-4041

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1922152503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305521",
            "telephone_number": "256-718-4041",
            "fax_number": "256-718-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305521",
            "telephone_number": "256-718-4041",
            "fax_number": "256-718-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "16182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "753040383",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51515546",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181487",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009996510",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51507189",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.