JODIE BETH NICHOLS DO
NPI 1821791369
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Q: What is Jodie Nichols's NPI number?

The NPI number for Jodie Nichols is 1821791369. It was assigned to this individual provider in the NPPES registry on March 23, 2023.

Q: What is Jodie 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 Jodie Nichols was last updated on March 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 March 23, 2023PECOS Enrolled

1300 N 12TH ST STE 320, PHOENIX, AZ 85006(602) 521-3050(602) 521-3046 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Jodie Beth Nichols Do NPPES

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

JODIE BETH NICHOLS DO (NPI 1821791369) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821791369

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJODIE BETH NICHOLSCredential: DO

Location Address1300 N 12TH ST STE 320Phoenix, AZ 85006-2858

Mailing Address1300 N 12th St Ste 320Phoenix, AZ 85006-2858

Phone(602) 521-3050

Fax(602) 521-3046

Sole ProprietorNo

Enumeration DateMarch 23, 2023

NPPES CertifiedMarch 23, 2023

✔ NPI 1821791369 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.

1300 N 12TH ST STE 320, Phoenix, AZ 85006

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jodie Beth 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.

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.

DR. BRIANA KHAN MD

Student in an Organized Health Care Education/Training Program