PHILLIP CONNOR NICHOLS DO
NPI 1710515838
Student in an Organized Health Care Education/Training Program in Charleston, WV
About Phillip Connor Nichols Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILLIP CONNOR NICHOLS DO (NPI 1710515838) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Phillip Connor Nichols Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Phillip Nichols reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Charleston, WV 25301
- Reassigned Medicare billing, West Virginia enrollment
- 1,511 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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.
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.
CHARLESTON, WV 25304
CHARLESTON, WV 25304
CHARLESTON, WV 25304
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 Phillip Nichols's NPI number?
The NPI number for Phillip Nichols is 1710515838. It was assigned to this individual provider in the NPPES registry on April 1, 2020.
Where is Phillip Nichols located?
Phillip Nichols practices at 3200 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-4600.
What is Phillip Nichols's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Phillip Nichols enrolled in Medicare?
Yes. Phillip Nichols is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Phillip Nichols's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Nichols reassigns Medicare benefits to Charleston Area Medical Center, Inc. (Charleston, WV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phillip Nichols's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Phillip Nichols accept?
Health plans from Highmark Blue Cross Blue Shield West Virginia list Phillip 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.
When was this NPI record last updated?
The NPPES record for Phillip Nichols was last updated on April 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Phillip Connor Nichols, DO · NPI 1710515838
Student in an Organized Health Care Education/Training Program provider in Charleston, West Virginia. Individual provider, active in the CMS NPPES registry since April 1, 2020.
## Identity
- **NPI:** 1710515838 (Entity type: Individual)
- **Enumerated:** April 1, 2020
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 3200 MACCORKLE AVE SE, Charleston, WV 25304-1297
- **Phone:** (304) 388-4600 · **Fax:** (304) 388-4621
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Charleston Area Medical Center, Inc. (NPI 1750166898, Charleston, WV), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 1, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1710515838) · Data from the CMS NPPES public registry.