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

Sex

Male

Sole proprietor

No

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.

• Community Memorial Hospital District

  • Family Medicine Physician
  • Appleton City, MO
  • NPI 1619117256

  Family Medicine, MO

  Medicare reassignment Care Compare group NPD
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Anderson, MO
  • NPI 1265428791

  MO

  Medicare reassignment NPD
• Community Memorial Hospital District

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

  • Rural Health Clinic/Center
  • Appleton City, MO
  • NPI 1861559817
  Care Compare group NPD (past)
• Community Memorial Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Appleton City, MO
  • NPI 1992730261
  Care Compare group
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1649837444
  NPD
• Ozark Tri-County Health Care Consortium

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

  • 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

  • Critical Access Hospital
  • Appleton City, MO
  • NPI 1609894716

  Hospital

  Care Compare affiliation

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 District 20 clinicians

Ozark Tri-County Health Care Consortium 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

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

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2022.

{
    "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.

• All providers in Joplin, MO
• 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.