PHILLIP CONNOR NICHOLS DO
NPI 1710515838
Student in an Organized Health Care Education/Training Program in Charleston, WV

Q: 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.

Q: 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.

Q: 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.

Active since April 01, 2020PECOS Enrolled

90.11/100

CMS Quality Rating

3200 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-4600(304) 388-4621 Get Directions Write a Review

NPPES record last updated: April 1, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 3, 2024, Aug 29, 2023, Apr 1, 2020 (3 updates tracked since 2020).

On this page

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

NPI1710515838

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NamePHILLIP CONNOR NICHOLSCredential: DO

Location Address3200 MACCORKLE AVE SECharleston, WV 25304-1297

Mailing Address3200 Maccorkle Ave SeCharleston, WV 25304-1297 · (304) 388-4600 · Fax (304) 388-4621

Phone(304) 388-4600

Fax(304) 388-4621

Sole ProprietorNo

Enumeration DateApril 1, 2020

Last NPPES UpdateApril 1, 20203 updates tracked since enumeration

NPPES CertifiedApril 1, 2020

✔ NPI 1710515838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3200 MACCORKLE AVE SE, Charleston, WV 25304

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Secondary Practice Locations 2

Location 1501 Morris StCharleston, WV 25301-1326 · Phone (304) 647-6006

Location 23200 MacCorkle Ave SE Fl 5Charleston, WV 25304-1297 · Phone (304) 388-4600 · Fax (304) 388-4603

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phillip Connor Nichols Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

37 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

17 services17 patients

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.

90.11/100

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

Scored through an Alternative Payment Model

Quality

66.96

Promoting Interoperability

100

Improvement Activities

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.

CAMERON DUBA DO

Emergency Medicine

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-4172

WILLIAM JARRETT WISEMAN BSN, RN, CCRN-CMC

Registered Nurse

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 993-1088

MS. BRENDA LOU KEEFER ANP

Nurse Practitioner (Family)

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 925-3436

LOUISE NAYLOR

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARSTON, WV 25304

Kanawha County (304) 388-4077

DR. JEFFREY V ASHLEY M.D.

Family Medicine

3200 MACCORKLE AVE SE, FIFTH FLOOR
CHARLESTON, WV 25304

Kanawha County (304) 388-4600

TIFFANY D. DUTTON CRNA

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE, DEPT. OF SURGERY
CHARLESTON, WV 25304

Kanawha County (304) 388-5503

JENNIFER D VALDEZ

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-5432

CHRISTOPHER S MULLINS

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 688-0228

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.

What insurance does Phillip Nichols accept?

Health plans from CareSource and 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.