Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Ryan Nickel

Individual provider Family Nurse Practitioner · NPI 1750167086

Justin Ryan Nickel is a Nurse Practitioner in Plano, Texas. Qualified in 2023, 3 years ago. Practices with Communitymed PLLC, a 46-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2023
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Practice location Address checks out

5208 Tennyson Pkwy Ste 100
Plano, TX 75024-7183
Phone: (844) 464-1611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1134807 (TX)

Record details

NPI number1750167086
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 4, 2023
Last updated in NPPESSeptember 4, 2023
Certification dateAugust 26, 2023
Mailing address1103 Daffodil St, Princeton, TX 75407-9794

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Communitymed Pllc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Plano