Individual provider Active NPI

Joshua Eric Nichols, O.D.

  • Optometrist
  • Somerset, KY
National Provider Identifier
1962440784
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1552DT Issued in KY
Practice address
165 Parker'S Mill Way
Somerset, KY 42503
Phone
(606) 677-0377
Fax
(606) 677-6542
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1552DT KY Primary

Addresses

Primary practice location

165 Parker'S Mill Way
Somerset, KY 42503

Mailing address

165 Parker'S Mill Way
Somerset, KY 42503
Phone (606) 677-0377

Other identifiers 1

IdentifierTypeStateIssuer
77000677MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060608000016 KY Practitioner - Optometry 2163316498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Health Specialists, PLLCGroup PAC ID 0749208239, 2 clinicians
Eye Health Specialists II PLLCGroup PAC ID 5294747317, 2 clinicians

Practice addresses (Care Compare)

165 Parkers Mill Way
Somerset, KY 42503-4151
Phone (606) 677-0377

713 E Main St
Stanford, KY 40484-1404
Phone (606) 365-3220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1552DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Specialists II, PLLC Optometrist CurrentSince Apr 1, 2006 Accepting new patients
Dr. J PSC Optometrist PastSince Feb 9, 2004 Accepting new patients

Locations

165 Parkers Mill Way
Somerset, KY 42503
Phone (606) 677-0377

713 E Main St
Stanford, KY 40484
Phone (606) 365-3220

Interoperability endpoints

  • Direct secure messaging: joshua@eyehealthofsomerset.eyefinitydirect.com

Organizations & group practices 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1962440784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 PARKER'S MILL WAY",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42503",
            "telephone_number": "606-677-0377",
            "fax_number": "606-677-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 PARKER'S MILL WAY",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42503",
            "telephone_number": "606-677-0377",
            "fax_number": "606-677-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOSHUA",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1552DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000677",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.