DR. GEORGE RICHARD NICHOLS (NPI# 1073730693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073730693 |
| Entity Type | Individual |
| Full Name | DR. GEORGE RICHARD NICHOLS |
| Credential | M.D. |
| Practice Address |
303 N Keene St Suite 201 Columbia MO 65201-7193 |
| Practice Telephone | 5738761000 |
| Practice Fax Number | 5734427899 |
| Mailing Telephone | 5738761000 |
| Mailing Fax Number | 5734427899 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2010-03-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2008016028 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | STATE LICENSE | 2008016028 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821283292 | George F Nichols | Dentist | 310 Beech St, Hackensack, NJ 07601-2125 | 2007-09-10 |
| 1073660577 | George R Nichols II | Legal Medicine | 6013 Brownsboro Park Blvd, Suite D, Louisville, KY 40207-1293 | 2007-01-05 |
| 1609883040 | George T Nichols | Psychologist | 1014 Vaquero Rd, Pebble Beach, CA 93953-2734 | 2006-08-01 |
| 1770035313 | George Nichols | Psychologist | 3326 Durham Chapel Hill Blvd Ste 230, Durham, NC 27707-6239 | 2016-10-31 |
| 1588637599 | George L. Nichols Jr. | Pathology | 321 Mulberry St Sw, Lenoir, NC 28645-5720 | 2006-02-09 |
| 1427050152 | George K Nichols | Orthopaedic Surgery | 3450 11th Ct, Suite 302a, Vero Beach, FL 32960-5012 | 2005-08-12 |
| Street Address |
303 N KEENE ST SUITE 201 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-7193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992796577 | Kathleen Wlaton David | Family Medicine | 303 N Keene St, Suite 301, Columbia, MO 65201-7193 | 2005-11-02 |
| 1366996050 | Tia Bruce | Nurse Practitioner | 303 N Keene St, Suite 404, Columbia, MO 65201-7193 | 2016-08-10 |
| 1144673906 | Columbia Family Medical Services, Inc. | Family Medicine | 303 N Keene St, Suite 301, Columbia, MO 65201-7193 | 2016-07-18 |
| 1720440035 | Sarah E Ondocsin | Speech-Language Pathologist | 303 N Keene St, Suite 401, Columbia, MO 65201-7193 | 2016-03-25 |
| 1457731259 | Graham Michael Tinker | Dentist | 303 N Keene St, Ste. 206-210, Columbia, MO 65201-7193 | 2015-06-05 |
| 1013306042 | Carly Zimmerman | Physical Therapist | 303 N Keene St, Ste 102, Columbia, MO 65201-7193 | 2015-01-14 |
| 1861800070 | Sport and Spine Rehab | Health Maintenance Organization | 303 N Keene St, Ste 102, Columbia, MO 65201-7193 | 2014-07-31 |
| 1376951590 | Shelton Blevins | Physical Therapist | 303 N Keene St, Ste 102, Columbia, MO 65201-7193 | 2014-07-31 |
| 1558781278 | Flow's Pharmacy, Inc | Pharmacy | 303 N Keene St, Columbia, MO 65201-7193 | 2014-04-21 |
| 1831538594 | Angela Rose Weis | Legal Medicine | 303 N Keene St, Ste 102, Columbia, MO 65201 | 2013-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
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| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083693857 | Carolina Dermatology Grp | Dermatology | 1706 St Julians Place, Columbia, SC 29204-2410 | 2006-01-11 |
| 1013145234 | Andrew Michael Basnett | Dermatology | 401 N Keene St, Columbia, MO 65201 | 2009-06-25 |
| 1609960509 | Columbia Dermatology, Inc | Dermatology | 401 N Keene St, Columbia, MO 65201-6625 | 2006-10-03 |
| 1972576536 | Csc Acquisition, LLC | Dermatology | 3600 Forest Dr Ste 400, Columbia, SC 29204-4057 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982140265 | Forefront Dermatology, S.c. | Dermatology | 8567 Watson Rd, Webster Groves, MO 63119 | 2017-01-11 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1730352394 | First Capitol Dermatology, L.L.C. | Dermatology | 901 S. 5th St., First Capitol Dermatology, L.L.C., St. Charles, MO 63301-2416 | 2008-04-03 |
| 1124223011 | Ramona Behshad | Dermatology | 2315 Dougherty Ferry Rd Ste 200a, Saint Louis, MO 63122-3383 | 2007-06-19 |
| 1518925312 | Henry W Clever IIi | Dermatology | 901 S 5th St, St Charles, MO 63301 | 2006-05-02 |
| 1013912906 | George J. Hruza | Dermatology | 1001 Chesterfield Pkwy E, Ste 101, Chesterfield, MO 63017-2041 | 2005-06-16 |
| 1225482839 | United Skin Specialists Missouri Ltd, PC | Dermatology | 1001 Chesterfield Pkwy E, Suite 101, Chesterfield, MO 63017-2167 | 2016-04-20 |
| 1891179040 | Forefront Dermatology, S.c. | Dermatology | 12855 N 40 Dr, Suite 180, Saint Louis, MO 63141 | 2015-07-17 |
| 1003290156 | Forefront Dermatology, S.c. | Dermatology | 1223 Maple St, Farmington, MO 63640 | 2015-07-17 |
| 1649542150 | Erickson Skin Surgery & Dermatology, LLC | Dermatology | 555 N New Ballas Rd, Suite 260, Saint Louis, MO 63141-6825 | 2012-01-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.