BLAKE E NICHOLS M.D.
NPI 1144583469
Pediatrics - Pediatric Critical Care Medicine in Fort Worth, TX

Q: What is Blake Nichols's NPI number?

The NPI number for Blake Nichols is 1144583469. It was assigned to this individual provider in the NPPES registry on June 21, 2012.

Q: What is Blake Nichols's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Blake Nichols was last updated on February 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 21, 2012PECOS EnrolledAccepts Medicare Assignment

74.59/100

CMS Quality Rating

801 7TH AVE, FORT WORTH, TX 76104(682) 885-7942(682) 885-7956 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 23, 2023, Aug 13, 2018 (2 updates tracked since 2018).

On this page

About Blake E Nichols M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE E NICHOLS M.D. (NPI 1144583469) is an individual pediatric critical care medicine provider in Fort Worth, Texas, licensed in Texas (Q4480) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Cook Childrens Medical Center, and is a graduate of University Of Texas Southwestern Medical School At Dallas (2012).

NPPES Registry Identity

NPI1144583469

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameBLAKE E NICHOLSCredential: M.D.

Location Address801 7TH AVEFort Worth, TX 76104-2733

Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-6483 · Fax (682) 885-3113

Phone(682) 885-7942

Fax(682) 885-7956

Sole ProprietorNo

Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 2012

Enumeration DateJune 21, 2012

Last NPPES UpdateFebruary 23, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 23, 2023

✔ NPI 1144583469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in TX · Q4480

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedPediatricsTaxonomy 208000000X · License Q4480 (TX)

801 7TH AVE, Fort Worth, TX 76104

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blake E Nichols M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345598223

PECOS Enrollment IDI20180809000630

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cook Childrens Medical Center

Childrens · Fort Worth, TX

OwnershipVoluntary non-profit - Private

CMS Certification Number453300

Location801 Seventh AvenueFort Worth, TX 76104 · Tarrant County

Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.59/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

56.12

Promoting Interoperability

100

Improvement Activities

Cost

59.2

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL MARIE SOUERS M.D.

Pediatrics

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-6726

JAMIE L COLE LCSW

Social Worker (Clinical)

801 7TH AVE, CASE MANAGEMENT
FORT WORTH, TX 76104

Tarrant County (682) 885-3991

ANNE MARCUM KIRK M.D.

Hospitalist

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-1475

KRISTI E TUCKER FNP

Nurse Practitioner (Family)

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-1475

ISAAC WILSON RN

Registered Nurse

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-4000

DR. BRITTON MICHAEL DEVILLIER M.D., M.P.H.

Emergency Medicine (Pediatric Emergency Medicine)

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-4095

DR. PHUONG THI NGUYEN M.D.

Hospitalist

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-1475

DR. MIRIAM ALLISON BLUM DO

Hospitalist

801 7TH AVE
FORT WORTH, TX 76104

Tarrant County (682) 885-1475

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Nichols's NPI number?

The NPI number for Blake Nichols is 1144583469. It was assigned to this individual provider in the NPPES registry on June 21, 2012.

Where is Blake Nichols located?

Blake Nichols practices at 801 7th Ave, Fort Worth, TX 76104. The listed phone number is (682) 885-7942.

What is Blake Nichols's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Blake Nichols enrolled in Medicare?

Yes. Blake Nichols is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Blake Nichols accept?

Health plans from Imperial Insurance Companies, Inc. list Blake Nichols as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Blake Nichols affiliated with any hospitals?

According to CMS data, Blake Nichols is affiliated with Cook Childrens Medical Center.

When was this NPI record last updated?

The NPPES record for Blake Nichols was last updated on February 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.