Jared Wade Nichols, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

2016007756 Issued in MO

Practice address

2901 Saint Johns Blvd
Joplin, MO 64804-1598

Phone

(417) 208-0733

NPI assigned

Jun 19, 2014

Last updated

Jan 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Family Practice

Education

At Still University, Arizona School of Dentistry & Oral HLTH, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Memorial Hospital DistrictGroup PAC ID 0345153680, 20 clinicians

Ozark Tri-County Health Care ConsortiumGroup PAC ID 8123918257, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellett Memorial Hospital Hospital, Appleton City, MO, CCN 261301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jared.nichols@othcdafc.eclinicaldirectplus.com

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.

• Community Memorial Hospital District

  dba AC Rural Health Clinic

  • Family Medicine Physician
  • Appleton City, MO
  • NPI 1619117256
  Medicare reassignment Care Compare group NPD
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Anderson, MO
  • NPI 1265428791
  Medicare reassignment Care Compare group NPD
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1649837444
  NPD
• Community Memorial Hospital District

  dba Ellett Memorial Hospital

  • Critical Access Hospital
  • Appleton City, MO
  • NPI 1609894716
  NPD (past)
• Community Memorial Hospital District

  dba AC Rural Health Clinic

  • Rural Health Clinic/Center
  • Appleton City, MO
  • NPI 1861559817
  NPD (past)
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1538151733
  NPD (past)
• Ozark Tri-County Health Care Consortium

  dba Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Carthage, MO
  • NPI 1992995120
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Hospital District

  dba Ellett Memorial Hospital

  • Critical Access Hospital
  • Appleton City, MO
  • NPI 1609894716
  Care Compare affiliation

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1982018727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SAINT JOHNS BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041598",
            "telephone_number": "417-208-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SAINT JOHNS BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041598",
            "telephone_number": "417-208-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JARED",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2016007756",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MO",
            "license": "2016007756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NHC Healthcare-Joplin LLC
• Nicholas J. Moore DDS, LLC
• Nicholas Moore DDS LLC
• Greta Jane Nicholas, M.S. CCC-SLP
• William John Nicholas, MD
• Joseph Lawrence Nichols
• Margaret Ellen Nichols, MD
• Matthew Nichols
• Emelie Grace Nickel
• Michael D. Nickell, M.D.

• Neuromusculoskeletal Medicine & OMM Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.