DAVID L NICHOLS PHD
NPI 1063409852
Psychologist - Counseling in Sturtevant, WI
About David L Nichols Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID L NICHOLS PHD (NPI 1063409852) is an individual counseling provider in Sturtevant, Wisconsin, licensed in Wisconsin (943-057) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Racine, and is a graduate of State University Of New York At Buffalo School Of Medicine (1980).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
David L Nichols Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show David Nichols reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sturtevant, WI 53177
- Reassigned Medicare billing, Wisconsin enrollment
- 5 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STURTEVANT, WI 53177
STURTEVANT, WI 53177
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is David Nichols's NPI number?
The NPI number for David Nichols is 1063409852. It was assigned to this individual provider in the NPPES registry on October 5, 2005.
Where is David Nichols located?
David Nichols practices at 8700 Durand Ave Ste 600, Sturtevant, WI 53177. The listed phone number is (262) 635-5520.
What is David Nichols's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Counseling, with taxonomy code 103TC1900X.
Is David Nichols enrolled in Medicare?
Yes. David Nichols is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for David Nichols's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Nichols reassigns Medicare benefits to Psychiatric Services Of Racine, LLP (Sturtevant, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Nichols's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Nichols accept?
Health plans from CareSource (Common Ground Healthcare), HealthPartners, Network Health and UnitedHealthcare list David Nichols as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for David Nichols was last updated on March 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# David L Nichols, PHD · NPI 1063409852
Counseling provider in Sturtevant, Wisconsin. Individual provider, active in the CMS NPPES registry since October 5, 2005.
## Identity
- **NPI:** 1063409852 (Entity type: Individual)
- **Enumerated:** October 5, 2005
- **Primary specialty:** Psychologist - Counseling · taxonomy 103TC1900X
- **State license:** 943-057 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 8700 DURAND AVE STE 600, Sturtevant, WI 53177-2096
- **Phone:** (262) 635-5520 · **Fax:** (262) 635-5530
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Psychiatric Services Of Racine, LLP (NPI 1699791988, Sturtevant, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York At Buffalo School Of Medicine, class of 1980
## Record status
- **NPPES last updated:** March 27, 2018
- **Other identifiers:** Medicaid 39027600 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1063409852) · Data from the CMS NPPES public registry.