DR. GLENN W NICHOLS (NPI# 1831167675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831167675 |
| Entity Type | Individual |
| Full Name | DR. GLENN W NICHOLS |
| Credential | MD |
| Practice Address |
200 Medical Pkwy Suite 111 Chesapeake VA 23320-4911 |
| Practice Telephone | 7575479301 |
| Practice Fax Number | 7575489263 |
| Mailing Telephone | 7575479301 |
| Mailing Fax Number | 7575489263 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0101036679 | VA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | BLUE CROSS BLUE SHIELD | 140351 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720100142 | Glenn Robert Nichols | Technician/Technologist | 16 King Philip Ave, South Deerfield, MA 01373-1127 | 2007-04-05 |
| Street Address |
200 MEDICAL PKWY SUITE 111 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23320-4911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699933747 | Orthopedic and Diagnostic Institute of Va | Orthopaedic Surgery | 200 Medical Pkwy, Suite 111, Chesapeake, VA 23320-4911 | 2008-05-27 |
| 1295913812 | Digitrace Care Services Inc | Durable Medical Equipment & Medical Supplies | 200 Medical Pkwy, Suite 109, Chesapeake, VA 23320-4911 | 2008-02-06 |
| 1366631236 | Orthopaedic & Sports Specialists Inc | Orthopaedic Surgery | 200 Medical Pkwy, Suite 111, Chesapeake, VA 23320-4911 | 2007-10-17 |
| 1013101765 | Hand Works, Inc. | Clinic/Center | 200 Medical Pkwy, Suite 210, Chesapeake, VA 23320-4911 | 2007-09-05 |
| 1649460635 | Hand Surgery Associates, P.C. | Orthopaedic Surgery | 200 Medical Pkwy, Suite 210, Chesapeake, VA 23320-4911 | 2007-07-26 |
| 1851597512 | Digitrace Care Services, Inc | Durable Medical Equipment & Medical Supplies | 200 Medical Pkwy, Suite 109, Chesapeake, VA 23320-4911 | 2007-06-21 |
| 1851418263 | Medical & Surgical Eye Specialists Inc | Eyewear Supplier (Equipment, not the service) | 200 Medical Pkwy, Suite 209, Chesapeake, VA 23320-4911 | 2007-03-23 |
| 1508996232 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 200 Medical Pkwy, Suite 109, Chesapeake, VA 23320-4911 | 2007-03-06 |
| 1184719353 | Medical & Surgical Eye Specialists Inc | Optometrist | 200 Medical Pkwy, Suite 209, Chesapeake, VA 23320-4911 | 2006-10-04 |
| 1285645127 | Alice Elaine Raja | Physical Therapist | 200 Medical Pkwy, Suite 210, Chesapeake, VA 23320-4911 | 2006-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1538624804 | Shaniqah Mcleod | Home Health | 217 Centerville Turnpike N, Chesapeake, VA 23320 | 2019-01-31 |
| 1942764113 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1400 Kempsville Rd, Virginia Beach, VA 23320 | 2019-01-22 |
| 1639647993 | Madison Vansavage Maben | Orthotist | 433 Network Sta, Chesapeake, VA 23320 | 2018-11-05 |
| 1568947356 | Kelly M Muchetti | Massage Therapist | 1421 C. Kempsville Rd., Chesapeake, VA 23320 | 2018-09-27 |
| 1235612912 | L&s Home Health Care, LLC. | Home Health | 1545 Cossways Blv, Chesepeake, VA 23320 | 2018-09-10 |
| 1154803500 | Latricia A Patterson | Home Health | 813-a Professional Pl Ste 107, Chesapeake, VA 23320 | 2018-09-02 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1831676105 | Lance Taylor | Technician | 1645 Crossways Blvd Ste 250, Chesapeake, VA 23320 | 2018-07-19 |
| 1023507688 | Sentoria Howell Harold | Social Worker | 920 Ventures Way Ste 4, Chesapeake, VA 23320 | 2018-05-08 |
| Find all providers in zip 23320 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626235 | Tidewater Surgical | Specialist | 1732 S Park Ct, Chesapeake, VA 23320-8934 | 2020-03-31 |
| 1376822940 | Alan A Smith | Specialist | 549 Royal Grant Dr, Chesapeake, VA 23322 | 2011-08-12 |
| 1396057022 | Pulmonary Associates of Tidewater | Specialist | 100 Wimbledon Square, Chesapeake, VA 23320-4931 | 2010-07-10 |
| 1528264959 | Brinda Dixit Inc | Specialist | 516 Innovation Dr Ste 204, Chesapeake, VA 23320-3866 | 2007-06-22 |
| 1528263720 | Coastal Surgical Assistance, Inc. | Specialist | 1102 Waterstone Ct, Chesapeake, VA 23320-3307 | 2007-06-18 |
| 1215138508 | Osborne Orthopedic Group Inc. | Specialist | 1101 Executive Blvd Ste D, Chesapeake, VA 23320-3634 | 2007-05-31 |
| 1255452413 | Dr Paul J Kovalcik M.d. Ltd | Specialist | 3105 American Legion Rd, Suite A, Chesapeake, VA 23321-5654 | 2007-04-03 |
| 1114042785 | Shannon Clinite Almberg | Specialist | 1502 Bodine Ct, Chesapeake, VA 23322-1745 | 2007-03-20 |
| 1477560902 | Fred Harris Siegel | Specialist | 700 Battlefield Blvd N Ste A, Chesapeake, VA 23320-4952 | 2006-08-01 |
| 1114952587 | Stephanie Jones Marioneaux | Specialist | 1013 Eden N Way E, Chesapeake, VA 23320-2792 | 2006-07-12 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23320 |
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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.