Edward Atkinson Nichols, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

093296-1 Issued in NY

Practice address

210 W 139TH St
New York, NY 10030-2109

Phone

(212) 234-2121

Fax

(212) 234-1759

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1952476053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 139TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302109",
            "telephone_number": "212-234-2121",
            "fax_number": "212-234-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 139TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302109",
            "telephone_number": "212-234-2121",
            "fax_number": "212-234-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "EDWARD",
        "middle_name": "ATKINSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "093296-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00151804",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLU SHIELD",
            "identifier": "676432",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Nichols, M.A., L.C.S.W.
• Cassie Nichols, LPN
• Christiana Celeste Nichols, MD
• Christine Elizabeth Nichols, MS,L.AC.
• Clark Matthew Nichols, PH.D.
• Gwen Lucille Nichols, M.D.
• Jamie E Nichols, M.D.
• Jeffrey N. Nichols, M.D.
• Karimah Nichols, LMSW
• Katherine Nichols

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.