Blake E Nichols
M.D. | Pediatric Critical Care Medicine | Male
Blake E Nichols, M.D. is a Fort Worth, Texas based Pediatric doctor with medical specialization in
Pediatric Critical Care Medicine.
Current practice location of Blake E Nichols is
801 7th Ave, Fort Worth, Texas - 76104-2733. He can be contacted on phone at
682-885-7942 and fax number 682-885-7956.
Blake E Nichols is a sole proprietor of his business.
NPI number (Unique professional ID) for Blake E Nichols is
1144583469 which was assigned by NPPES on 21 Jun, 2012 and it was last updated on 23 Feb, 2023.
Blake E Nichols license number is
q4480 for Pediatrics, Pediatric Critical Care Medicine (2080P0203X) in Texas.
Blake E Nichols is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Blake E Nichols basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics, Pediatric Critical Care Medicine |
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| Provider Name : | Blake E Nichols |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Blake E Nichols address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 801 7th Ave
Fort Worth, TX, 76104-2733
United States |
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| Phone Number : | 682-885-7942 |
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| Fax Number : | 682-885-7956 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1144583469 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 21 Jun, 2012 |
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| Last Updated On : | 23 Feb, 2023 |
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Medicare Participation:
Blake E Nichols participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 0345598223 |
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| Medicare Enrollment ID : | I20180809000630 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | University Of Texas Southwestern Medical School At Dallas |
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| Graduation Year : | 2012 |
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| Accepts Medicare? | Yes. Blake E Nichols accepts medicare insurance. |
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Group Practice Association:
Blake E Nichols is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Blake E Nichols is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| University Of Texas Southwestern Medical Center | 0648188250 | 2495 | 1935 Medical District Dr
Dallas, TX - 752357701
Ph: 8444244537 | Yes |
| Cook Childrens Physician Network | 7719884584 | 201 | 801 7th Ave
Fort Worth, TX - 761042733
Ph: 6828857942 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Blake E Nichols are as mentioned. Primary taxonomy code for Blake E Nichols, M.D. is
2080P0203X (Pediatrics, Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 208000000X | Pediatrics | No | q4480 | TX |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | Yes | q4480 | TX |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
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DIRECT
(Direct Messaging Address) | bnichols194755@CookChildrens.direct-ci.com
| No affiliation |
|
| 801 7th Ave,
Fort Worth, TX, 76104-2733
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 733784
Dallas, TX, 75373-3784
United States |
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| Phone Number : | 682-885-6483 |
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| Fax Number : | 682-885-3113 |
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Business Location:
Patients can refer following map for directions to
Blake E Nichols practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.