Russel James Nichols, MD | |
130 Thompson Avenue, Heppner, OR 97836 | |
(541) 676-5504 | |
(541) 676-8247 |
Full Name | Russel James Nichols |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 26 Years |
Location | 130 Thompson Avenue, Heppner, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730187436 | NPI | - | NPPES |
287633 | Medicaid | OR | |
106707 | Other | OR | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MD22062 (Oregon) | Secondary |
207Q00000X | Family Medicine | MD00039026 (Washington) | Secondary |
207P00000X | Emergency Medicine | MD22062 (Oregon) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Good Shepherd Home Health | Hermiston, OR | Home health agency |
St Anthony Hospital | Pendleton, OR | Hospital |
Pioneer Memorial Hospital (heppner) | Heppner, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Anthony Hospital | 3678568268 | 21 |
Umatilla River Emergency Physicians Llc | 5991075475 | 13 |
Entity Name | Good Shepherd Health Care System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295789667 PECOS PAC ID: 9133033764 Enrollment ID: O20031118000046 |
Entity Name | St Anthony Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831169903 PECOS PAC ID: 3678568268 Enrollment ID: O20040414001635 |
Entity Name | Umatilla River Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295263523 PECOS PAC ID: 5991075475 Enrollment ID: O20170714002880 |
Mailing Address | Practice Location Address |
---|---|
Russel James Nichols, MD Po Box 9, 564 E Pioneer Dr, Heppner, OR 97836 Ph: (541) 676-5504 | Russel James Nichols, MD 130 Thompson Avenue, Heppner, OR 97836 Ph: (541) 676-5504 |